Original Letter online at https://fluoridefreeaustralia.org/open-letter-ada-nsw/
On 17 February 2021, Port Macquarie-Hastings Council confirmed a community poll on water fluoridation will be held later this year.
In response to this decision, Dr Kathleen Matthews, President of the NSW Branch of the Australian Dental Association, has been outspoken in the media, criticising PMH Council for its “baseless” objection to fluoridation.
In this open letter, we respond to Dr Matthews and ask if she will continue to mislead the people of Port Macquarie Hastings and other Australians about this highly contentious and vitally important issue of water fluoridation.
16 March 2021
Dear Dr Matthews
We were extremely surprised by your recent comment in the media, saying:
We realise this comment reflects your organisation’s official position, but you appear to have been misled yourself because this statement is unfortunately not true.
In this letter we will respond to the three aspects you mention above – safety, efficacy and equality – and ask you some important questions along the way.
EFFICACY
It’s remarkable – 40 per cent less tooth decay!
Your statement that fluoridated water reduces dental decay by around 40 per cent is extremely misleading. So on 24 February 2021 we asked you by email to provide the source of your claim. In the absence of a response from you, we suspect this 40 per cent figure originally came from a document titled “Water Fluoridation: Nature’s Way to Prevent Tooth Decay.” This document, dated 2006 was produced by the American Dental Association in collaboration with the US Centers for Disease Control and Prevention and is a promotional document conspicuously lacking in science.
Having analysed in detail the published, peer-reviewed science of water fluoridation for years, we are fed up with promotional slogans by fluoridation promoters such as yourself, without any substantiating scientific evidence provided.
Nine years after the publication of this promotional ADA/CDC document, the science of fluoridation was meticulously clarified. In 2015 the Cochrane Collaboration, acknowledged internationally as the gold standard in the review of health science, published the results of the largest, most comprehensive meta-review ever conducted on the effectiveness of water fluoridation. This meta-review is referred to as the Cochrane Review (2015).1
Dr Matthews, has anyone made you aware of this globally important meta-review? If so, you would know that:
1. Not one single published Australian fluoride efficacy study met the relaxed inclusion criteria for this comprehensive meta-review;
2. Of the 277 studies initially regarded eligible by the Cochrane team, only 19 studies conducted between 1951 and 2015 met the final inclusion criteria for dental caries, although a majority (around 70 per cent) of these studies were conducted before 1975. All 19 of these studies were deemed to be poor quality;
3. In the review’s summary findings, the authors found no high-quality research showing that:
– Fluoridation provided any benefit to adults;
– Fluoridation provided additional benefits over and above topically applied fluoride;
– Fluoridation reduced inequalities among children from different socio-economic groups; or that
– Tooth decay increased in communities when fluoridation is stopped.
4. The Cochrane team also regarded the studies claiming to show that water fluoridation reduces decay in children as not applicable to today’s society, as nearly all the studies reviewed (dating back to the 1940s – 1960s) had a high risk of bias and were conducted prior to the availability of fluoride toothpaste and other sources of fluoride.
As water fluoridation is forced on communities it is even more important that this highly-controversial health intervention is based on sound, quality science. Unfortunately, since the Cochrane Review, and a substantial-and-growing body of other scientific evidence, it can no longer be said with any truthfulness that water fluoridation is backed by solid science.
Your statement to the Port Macquarie-Hastings community was therefore a GROSS MISREPRESENTATION of the published science now available.
If you have been relying on indirect advice from others regarding the science, we suggest you personally read the full Cochrane Review, or at least its key findings, before venturing again to inform any community about fluoridation and tooth decay.
Is this misleading or is it deception?
The history of water fluoridation is riddled with misrepresentations and promotional misinformation.
For example, in our article titled The history of fluoride in Queensland – “65% less tooth decay”, we point out the deceptive use of merely relative decay percentage rates.
In the notorious 1996 Townsville-Brisbane study2, used by the Queensland State Government in 2007 to promote fluoridation, the fluoridated Townsville group had on average 0.09 decayed, missing or filled surfaces (DMFS), compared to the unfluoridated Brisbane group with an average 0.26 DMFS.
That means a difference of just 0.17 of one tooth surface amongst 120 total surfaces, being an absolute reduction of just 0.14 per cent or less than a quarter of one percent!
To represent those results as showing an astounding 65 per cent reduction in decay, is reminiscent of a snake-oil salesman, and is therefore grossly misleading to the community.
Similarly, your claim of a “40 per cent reduction” in tooth decay sounds impressive, but in actual terms translates to a fraction of a tooth surface difference.
More deception?
Perhaps your claim was also influenced or reinforced by comments made by New Zealand’s Ministry of Health and subsequent comments by the President of the New Zealand Dental Association, that water fluoridation reduces dental decay by 40 per cent.
That claim from our trans-Tasman neighbour is based on the 2009 Sapere Report, sponsored by the New Zealand Ministry of Health and derived from a MOH survey using data from 2008.3 The 2009 report is based on an examination of only around 65 children in each age group, which was then unjustifiably and misleadingly used to extrapolate to a national forecast saving in dental decay rates that would exceed the cost of implementing fluoridation for the whole country. As Fluoride Free New Zealand points out, extrapolating from such a small selective study is hugely misleading.
It is also ironic that despite the impressive claim, regular, more comprehensive dental surveys conducted by MOH show a very different picture. The MOH table below (dated 16 November 2018) shows the dental health status of children aged five in 2017 and reveals the so called 40 per cent improvement in fluoridated areas to be complete nonsense.
The overall difference for New Zealand is actually 1.79 per cent. The green numbers, however, show that eight regions, especially ethnic groups in these regions, had SIGNIFICANTLY LESS tooth decay in NON-fluoridated areas, while the blue numbers show a difference of less than five per cent; i.e. virtually the same.
A similar profile can be found in almost every MOH dental health survey collected in New Zealand, revealing that MOH’s own data proves them wrong!
Shall we conveniently ignore all large-scale studies?
Dr Matthews, we strongly encourage you to suspend your cherry picking and fluoride proselytising and read our article; Water fluoridation is not effective. In this article we reveal that all large-scale, population-based fluoride efficacy studies conducted since the original 1950s studies (studies that have been shown to be erroneous), clearly show that fluoridation DOES NOT reduce tooth decay.
Underlying statistics
Lastly, if drinking fluoridated water really does reduce tooth decay by around 40 per cent, then it would be reasonable to assume that Australia – one of the most fluoridated countries in the world – would have outstanding, or at least above-average, dental health. Unfortunately the official dental statistics continue to show otherwise.
Nearly 90 per cent of Australians receive fluoridated water and yet in March 2018, the Oral Health Tracker4 revealed that about 90 per cent of adults (15+) have had or will have some form of tooth decay. In November 2018, the Australian Institute of Health and Welfare5 reported that:
- 42 per cent of all children aged 5 to 10 have experienced tooth decay in their primary teeth;
- about 25 per cent of children aged 6 to 14 have experienced decay in their permanent teeth; and
- all Australians aged 15 and over have an average 12.8 decayed, missing or filled teeth amongst a total of 32 teeth.
In 2016-2017, AIHW also reported there was a staggering 132,700 hospitalisations involving general anaesthesia for dental procedures. In NSW alone, the state’s hospitalisation data shows that tooth decay and other preventable dental problems resulted in 16,700 NSW adults and children in hospital in 2015-16. The data also showed more than 100 children a week are having multiple rotting teeth extracted, filled and capped under general anaesthetic. In fact all capital cities in Australia (which are all fluoridated) are experiencing a dental decay epidemic or crisis amongst our children, with several cities reporting a record number of tooth extractions under anaesthetic for young children.
Fluoridation is clearly not working and yet dental professionals and other fluoride proponents have used these disturbing dental health statistics as an argument to increase the availability of fluoridated water throughout Australia.
Meanwhile, the 2020 Oral Health Checker (co-produced and sponsored by the Australian Dental Association) states that a massive 47.8 per cent of Australian adults (aged 19+) are consuming too much free sugar and that only 53 per cent of adults are brushing their teeth twice daily. Herein lies the real problem, NOT a lack of fluoridation.
SAFETY
Opinions or a substantial body of scientific evidence?
As of February 2021, a total of 68 studies conducted worldwide – with 58 of these based on water fluoridation – have found that fluoride consumption is associated with reduced IQ in humans. More than 60 animal studies, even at very moderate dose rates, have also found that fluoride exposure impairs the learning and/or memory capacity of animals.
Amongst the human studies, 66 studies were based on IQ examinations of more than 25,000 children, while two studies involved 245 adults. Together these studies provide compelling evidence that fluoride exposure during the early years of life can damage a child’s developing brain. You can see a full list of these studies here. For a short video on the effects of fluoride both on the developing brain and on a whole society, click here. Dr Matthews, is that really what you want for our children?
Amongst this steady stream of published, peer-reviewed science over 20 years, there have been SIX Mother-Offspring studies based on water fluoridation, showing the relationship between maternal fluoride ingestion and subsequent lowered IQ in their children.
In 2006 the US National Research Council published “Fluoride in Drinking Water”6 the most authoritative review of fluoride’s toxicity. It stated unequivocally that “fluorides have the ability to interfere with the functions of the brain and the body.”
In 2012 a Harvard-funded meta-analysis7 found that children ingesting higher levels of fluoride tested an average 7 IQ points lower in 26 out of 27 studies. Most had higher fluoride concentrations than in US and Australian water, but many had total exposures to fluoride no more than what millions of Americans and Australians receive from mandatory water fluoridation.
In 2015, Malin and Till8 empirically demonstrated an association between widespread exposure to fluoridated water and increased ADHD prevalence in US children and adolescents.
Since 2017, EIGHT major studies and reviews have confirmed that fluoride damages the developing brain, at exposure levels the same as from artificial water fluoridation:
Summary of the eight major fluoride neurotoxicity studies since 2017
- The Bashash study (2017), a National Institutes of Health (NIH) – funded study in Mexico covering 13 years found that every one milligram per liter (1 mg/L) increase in fluoride in pregnant women’s urine – approximately the difference caused by ingestion of fluoridated water – was associated with a reduction of their children’s IQ by an average 5-6 points.
- The Till study (2018), a Canadian study found iodine-deficient adults (nearly 18% of the population) with higher fluoride levels had a greater risk of hypothyroidism (known to be linked to lower IQs). Author Ashley Malin said “I have grave concerns about the health effects of fluoride exposure.”
- The Green study (2019), another NIH-funded study, published in the Journal of the American Medical Association Pediatrics, found every 1
mg/L increase in fluoride in Canadian pregnant women’s urine was linked to a 4.5 decrease in IQ in their male children. The physician editor of JAMA Pediatrics said “I would not have my wife drink fluoridated water” if she was pregnant.
A detailed article about this study is available HERE.
MUST READ: A number of criticisms by pro-fluoridationists have been made about this study. A response to these criticisms is available HERE. The JAMA Pediatrics Editor-in-Chief reported in an editorial on the journal’s stats for 2019, including the top three articles ranked by Altmetric score. Green et al. ranked number one. More details available HERE. - The Riddell study (2019), found that children in fluoridated areas have nearly THREE TIMES the risk of ADHD compared with children in non-fluoridated areas.
- The Till study (2019) another NIH-funded study, found that babies fed formula mixed with fluoridated water averaged 4 IQ points less than those mixed with non-fluoridated water. Losses of non-verbal IQ were even more serious, an average of 9 points.
- The US National Toxicology Program Review (2019), a systematic review of 149 human studies and 339 animal studies concluded that “fluoride is presumed to be a cognitive neurodevelopmental hazard to humans.” In February 2021, the National Academy of Sciences published its final peer review of the NTP Review, strengthening NTP’s original conclusion. More details HERE. Watch a video summary HERE.
- The Grandjean Review (2019), Developmental fluoride neurotoxicity: an updated review concluded; “The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable.”
- The Malin study (2019), found that in adolescents aged 16 – 19 years living with fluoridated water, there was a doubling of symptoms indicative of sleep apnoea, compared with those with low fluoride water.
A detailed summary including links to these studies is available HERE.
Many studies, including those considered in the NRC Review (2006), also show fluoride damages the kidneys, thyroid gland, pineal gland, bones and teeth; inhibits enzymes and cell proteins and contributes to iodine deficiency. For summaries, please read our articles Water fluoridation is not safe and A steady stream of science.
It is ironic that fluoridation causes damage to the teeth it is supposed to protect. Even NHMRC admits 25 per cent of children in Australia have dental fluorosis9 and at least 3.4 per cent of NSW children have moderate to severe fluorosis and yet fluoridation is still forced on NSW councils. But as we point out in this article, the rates of dental fluorosis in Australia are probably drastically understated. Residents of NSW and others should also be concerned that if fluoride is causing damage to their teeth, i.e. the hardest tissue or substance in our body, then as many studies suggest, it’s doing even more damage to all the soft tissues and organs in our body.
You should also be aware that several of the large fluoride-developmental-neurotoxicity studies received considerable funding from US Government agencies such as NIEHS, NIH and EPA. In order to receive this funding the research teams, often from major universities and medical research institutes, were required to demonstrate their research protocols were adequate if not rigorous for the research task involved.
Lastly, we suggest that you do not refer to these studies as having been properly considered by NHMRC, as they demonstrably have not.
Nature’s way!
Really Dr Matthews???
Fluoride – as calcium fluoride – is indeed found in sea water, at a concentration of around 1 milligram per litre, approximating the concentration of “fluoride” in Australian fluoridated drinking water. But it is obviously absurd, and an insult both to the intelligence of Australians and your professional position, to compare the ingestion of very small amounts of sea water while swimming with a lifetime of consuming fluoridated tap water.
It is also misleading to suggest that because fluoride (as calcium fluoride) is a naturally occurring element found in rocks, sea water and some artesian water, that it is safe for humans.
The man-made, industrial-waste chemical used for fluoridation has never been proven safe for human consumption. And there are specific health implications from synthetic fluoride. For example, several studies by Masters et al10,11,12 found the use of hexafluorosilicic acid or silicofluorides resulted in an increased uptake of lead into children’s blood, but they did not find this association with naturally occurring calcium fluoride. This is a very serious finding given the well-documented neurotoxic effects of lead.
Dr Matthews, we strongly encourage you and all residents of Port Macquarie-Hastings to read our article; The source of fluoride: find out what you’re really drinking! As we state in this article, it is quite remarkable that health authorities and professionals go to extraordinary lengths, often using misleading and even false statements to defend and reinforce this irrational and scientifically-defunct policy of adding a very hazardous, toxic, industrial-waste chemical to our drinking water. Some of Australia’s health authorities even go as far as stating that fluoride is an essential nutrient which is not only absurd it’s false and blatant deception.
All residents of Port Macquarie-Hastings should know that the fluoridation chemical used predominately in Australia (including PMH) is actually a by-product resulting from the processing of agricultural fertiliser. To produce this fertiliser, phosphate rock is heated to more than 300 degrees and sulfuric acid is added to create “superphosphate”. In this process, two extremely toxic gasses are emitted which are captured by “scrubbing”, or the spraying of fine jets of water into the chimneys. This resulting chemical compound, known as hexafluorosilicic acid or hydrofluorosilicic acid, does not undergo any further treatment or processing. Instead, in its raw form, it is given the appealing name of “fluoride” and is transported straight to various water dosing plants around Australia and added directly to our drinking water.
EQUALITY AND ETHICS
In terms of equality and your suggestion that fluoridation benefits everyone, we again refer to the findings of the comprehensive Cochrane Review (2015) that directly contradicts your belief and statements. In particular, the Cochrane team found no high quality research showing that fluoridation reduced inequalities among children from different socio-economic groups.
In terms of ethics, we encourage you and other visitors to read our article titled Water fluoridation is not ethical. As we state in this article, “The arrogance surrounding the ethical considerations of mandatory water fluoridation in Australia is staggering and the tactics used to defend and promote the process of adding toxic fluoridation chemicals to our drinking water are also far from ethical.”
Water fluoridation is a violation of ethics for the following reasons:
- Fluoridation deprives the individual of their basic right to informed consent. Fluoridation allows government bodies to impose on the public what an individual doctor is prohibited from doing to any individual. Click on the image right to read the section on community consultation within the Australian Drinking Water Guidelines;
- Fluoridation provides an uncontrolled dose, depending on the volume of water consumed and the individual’s body weight. People who drink large quantities of water such as bottle-fed infants, outdoor workers, athletes and diabetics are particularly at risk;
- Fluoridation disregards an individual’s personal circumstances. Medical science understands well that individuals respond very differently to the same dose of a given medication. In fact the dose of a medication that is safe for one individual may be toxic for another and this applies very much to fluoride;
- Fluoridation does not involve a medical expert’s ongoing monitoring, unlike other medications. There is also no program or system in Australia or other fluoridating countries to track the level of fluoride building up in people’s tissues or bones, or to monitor for side effects. Despite the overwhelming evidence of harm and despite fluoridation being forced on the nation, Australia’s NHMRC admits it has never funded a single study into the potential adverse health effects of fluoridation chemicals on human health;
- Fluoridation effectively robs people of their choice. It is unacceptable that many individuals who, having informed authorities they do not consent, are still subjected to the medical treatment of fluoridation regardless;
- Fluoridation has never been proven safe. A Randomised Controlled Trial for water fluoridation has never been conducted and fluoride has never been approved by the US FDA or tested by Australia’s TGA. In fact the TGA has excluded fluoridation chemicals as a therapeutic good, despite this highly-controversial substance being added to our drinking water for therapeutic purposes. Many studies, including the prestigious US National Research Council’s comprehensive 2006 review “Fluoride in Drinking Water” clearly show that long-term, low-level consumption of fluoridation chemicals damages various aspects of human physiology;
- Fluoridation is arrogant and disrespectful. Fluoridation promoters argue that “fluoridation ensures that fluoride gets to those that need it most”. This is wrong on two counts: firstly no one “needs” to ingest fluoride, and secondly, the people they claim “need it most” are actually the people who are most likely to suffer from its toxic effects.
Although you haven’t recently referred to NHMRC’s review and endorsement of fluoridation, we feel it’s appropriate to briefly cover this issue as many health professionals, politicians and indeed members of the public, are not aware of this outstandingly poor review process and understandably rely on our peak medical research body. First, we strongly encourage you to read our detailed articles, Can the NHMRC be trusted? and The bioaccumulation of fluoride – a response to the NHMRC. As we state in the first article:
“…with a little examination it is clear that NHMRC’s past reviews of the safety, effectiveness and ethics of water fluoridation are at best unprofessional and at worst unscientific, biased, highly selective, restrictive of relevant and meaningful public input and deeply flawed in its methodology. In fact NHMRC’s agenda and approach to fluoridation is so biased and so misleading, it is verging on fraud.”
These articles are reinforced by the following:
- Despite a substantial and growing body of scientific evidence over more than 50 years clearly showing fluoridation chemicals cause various physiological damage, especially the mounting neuro-developmental science over the last 20 years, NHMRC had not conducted or funded one single long-term toxicology study;
- Despite all the neuro-toxicity evidence at hand, especially given the risk to the developing fetus, instead of considering a warning for pregnant mothers, NHMRC has arbitrarily DOUBLED the upper fluoride limits for infants and children. These limits are completely lacking in any biological justification and are now well above other fluoridating countries;
- Based on an extremely biased review process, NHMRC provides guidelines and recommendations but does not provide any guarantee of safety, which is especially concerning and negligent because fluoridation is forced on us for a lifetime;
- NHMRC has an obvious conflict of interest. As the “primary agency of the Australian Government responsible for medical and public health research”, our national health body must maintain its credibility and standing and therefore must continue to support a policy it has been endorsing and recommending for nearly 70 years. To suddenly reverse this policy would threaten or undermine the trust and reliance in this organisation and indeed the individuals within NHMRC who are responsible for this review process.
It is obvious that many fluoride-endorsing health professionals, such as yourself, have never investigated the science of fluoridation objectively or properly and continue to perpetuate this myth, largely based on NHMRC’s fluoridation review process and recommendations.
Unfortunately, it seems that water fluoridation is much more about protecting a politically popular policy; the appearance of consistent health information; the image of and trust in our national medical research body; and individual reputations, than it is about the science of chemistry and biology.
For these reasons we feel compelled to call for an independent review of water fluoridation and its dental and general health effects, so we can all benefit from accurate information and correct errors occurring in the past.
Sincerely
The Management Team
Fluoride Free Australia Inc.
Reference notes:
- Zipporah Iheozor?Ejiofor et al; “Water fluoridation for the prevention of dental caries”; Cochrane Collaboration/Cochrane Database of Systematic Reviews; 18 June 2015.
- J Spencer “Caries experience among children in fluoridated Townsville and unfluoridated Brisbane”Aust N Z J Public Health; 1996;20;623-9). Slade GD, Spencer AJ, Davies MJ, Stewart JF.
- New Zealand Ministry of Health. “Our Oral Health”; Key findings of the 2009 New Zealand Oral Health Survey; Published December 2010.
- AIHW, March 2018 Oral Health Tracker;
- AIHW November 2018 Report;
- US National Research Council, “Fluoride in Drinking Water”, 2006.
- Choi AL (a), Sun G, Zhang Y, Grandjean P. “Developmental fluoride neurotoxicity: a systematic review and meta-analysis.” Environ Health Perspect. 2012 Oct;120(10):1362-8. doi: 10.1289/ehp.1104912. Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.
- Ashley J Malin & Christine Till; “Exposure to fluoridated water and attention deficit hyperactivity disorder prevalence among children and adolescents in the United States: an ecological association.” Environmental Health volume 14, Article number: 17 (2015).
- NHMRC; “Draft Information Paper: Effects of water fluoridation on dental and other health outcomes”; Sep 2016.
- RD Masters and MJ Coplan; “Water treatment with silicofluorides and lead toxicity”; International Journal of Environmental Studies; 56, no.4 (1999).
- RD Masters and MJ Coplan; “Association of silicofluoride treated water with elevated blood levels”; Neurotoxicology 21, no.6 (2000);
- MJ Coplan, SC Patch, RD Masters, MS Bachman, “Confirmation of and explanations for elevated blood lead and other disorders in children exposed to water disinfection and fluoridation chemicals”; Neurotoxicology, Sep 2007 (5):1032-42.#
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