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OPINION ON FLUORIDE by Dr. Fred M. Timmermans

"The best medicine in the world without any side effect is a smiling face" Rhisika Jane

I am and most New Zealand dentists are concerned about the rise of dental decay in New Zealand in mainly children. Unfortunately this is now a worldwide issue after a period of decline. In my opinion it is a socio-economic phenomenon that has happened before and will recover in time with real investment in good health education. But not by starting another water fluoridation war as DHB's and the Dental Associations are trying to do again in both the UK and NZ.

The essence is simple: decide upon this matter according to the precautionary principle. With so much conflicting evidence for fluoride, it can never be admitted in our water.

History repeats itself: we have seen this happening in the 1950's in Europe where people gained their first income growth out of the post war "poorness" and the first luxury they spend their money on was carbonated sugar water and lollies. This is now happening with the many Maori, Asian and Pacific islands immigrants in New Zealand but also to a considerable part of the NZ - European population with lower socio-economic status, as was the outcome of the 2009 New Zealand Oral Health Survey. The difference is that in the 1950's ninety-nine percent of current junkfood choices did not exist. I was shocked at my arrival in NZ in 2007 to see how much more advertising time TV NZ has compared to Europe, how aggressive this was promoting all the wrong food choices, promoting terrible pharmaceuticals and promoting constant spraying of pesticides around the house. So I full-heartedly support the petition initiative by a group of concerned parents to stop the media targeting children with junk advertising. Please sign up too for the petition here: http://www.actionstation.org.nz/stop-marketing-at-our-children. My concern is that I feel and see that many adults are badly informed and badly influenced by the commercial brainwash that TV is. My advice is: the best health choice you will ever make that will extend your life with decades and reduce your stress levels wonderfully: get rid of your satellite disk! The internet provides with far better information choices then television can ever give and without brainwash...

WHY I DO NOT WANT WATER FLUORIDATION BECAUSE IT IS:

  • UNLOGICAL:  Less then 0.5% of tap water is used for drinking and this is far less for the group who needs it most, they get most drinks from bottles and then usually carbonated and carbohydrated (see my suggestions at the end of this opinion article)
  • UNECOLOGICAL: unwanted environmental loading of our waterways by unnatural toxic substance (a biocide waste product with contaminants very different from natural fluoride occurring in some natural ecosystems)
  • UNETHICAL: it is forced medication, which is almost impossible to remove or avoid
  • TOXICOLOGICALLY and physiologically strongly debatable: it is an untargeted form of medication which absolutely disregards actual individual intake requirements which can easily lead to a wrong individual dosage and affect many who do not need this at all. Example: most tea has natural NaF in it, drinking tea with fluoridated water will cause a higher then the advised 0.7 ppm concentration of fluoride. NZ is a tea drinking nation, so this is in my opinion unacceptable
  • UNACCEPTABLE politically in an open and free democracy (is this indirect proof of failing democracy in the US, about the only country that has lasting water fluoridation?) as is proven in all European countries where water fluoridation is  nearly non-existent. Most countries even filter the natural fluoride out as it is seen as an unwanted contaminant.
  • UNSCIENTIFIC: There is a war on fluoridation with very controversial research findings.  Conflict of interest taint nearly all medical/dental studies (see this alarming article from the editor of the New England Journal of Medicine). Nothing new really, already in 1965  Dr. G.L. Waldbott, M.D. wrote a very interesting review (you can download the whole book here) on the controversies and conflicts of interest he found in studies around the introduction of fluoridation. What he saw looked very similar to what John Colquhoun published in 1997 (full article below): your safety is not guaranteed! Other minerals in water or diet have a huge impact on our teeth as well, and can compromise the influence of fluoridation as was found when Hastings was compared with non fluoridated Napier: Napier had better teeth and still has 50 years later! This might have to do with the occurrence of Molybdenum traces in Napiers water (Link here).
  • In 1961 D.B. Richie from the university of Otago found that a group of 200 patients who had been supplemented for three years with Magnesium Phosphate had far better teeth compared with non supplemented patients (Nature, April 1961 p456-458) No one ever did follow up on this research, while it promised a great and SAFE alternative to fluoridation... Our practice advises many patients supplements with Magnesium, there is more research proving it to be preventative for gum health too and since it is often depleted in NZ soil, the presence in our food is fully dependent on the farmer using fertiliser with added Magnesium (which is not guaranteed...)
  • Fact is that the hydrofluorosilic acid used for water fluoridation is now labelled as a carcinogenic neurotoxin and was in use as a biocide.  Biocide manufactures since (only) 2007 have to prove that they are not dangerous for humans, hydrofluorosic acid was banned in Europe because no manufacturer dared to do this research (see link). But strange as it may sound for use in our drinking water this rule does not apply... So in essence it is one big chemical experiment with a very questionable substance which is a problem waste product from the fertiliser industry. Most of the time it does not even undergo purification and then has various contaminants especially arsenic. But Fluoride is not the only danger. Every year more new chemical formulas come on the market without any or minimal research on toxicity. It is in our food and many household products as toothpaste, soaps and shampoos and also in fillings! It is a horrifying brew we are in thanks to the chemical industry...

It is so simple to create a healthy mouth without any toxic additives in our water or toothpaste! Why does the profession so underestimate the effect that we can have with diet change advise that can create health and is an unique chance to prevent much more than just cavities? Fluoridation is  another attempt to disguise our disconnection from nature and healthy food. We are being slowly poisoned by the combined effect of environmental pollution and the never ending seduction for cheap carbohydrate rich, but empty food that the processed food industry offers us. Obesity and diabetes are absolutely not being cured by fluoridation, neither have I ever seen any real dental health effect from fluoride with persons who did not change their sugar rich carbo - lust diets. It is known since Weston Price did his fieldwork: as soon as our western diet (sugar, corn, wheat and alcohol) was introduced in newly acquired colonies, tooth decay became a problem. As it is also known that better educated and higher income populations have far less decay. They have learned to go back to cooking and growing their own slow food that was once the main course of the "non" civilised world.

Below is the conclusive evidence from the UK that fluoride does not have the qualities that we are usually been told and then a personal opinion from a dentist in Auckland about why he has changed his opinion on fluoride: most of the research is absolute junk science sponsored by the industry and/or the wanted outcome is created by selective data use by the researcher. I found a nice example of this done by the frequently quoted US Centre for Disease Control: compare the official York review below with the conclusions that the CDC quotes from this very same review (see this page: http://www.cdc.gov/fluoridation/safety/systematic.htm). They call this page systematic assessing the weight of evidence! Systematic lying? Not ONE word over the absolute lack of quality of the research itself. This is Modern Science. Welcome to a world of money and fraud. Recently: the 2009 New Zealand Oral Health Survey. Now in full use to promote fluoridation. Read the quote on this page: " the study was not designed as an in depth waterfluoridation study": yes we just keep doing it.....

And the junk science war has still not come to an end, one must be very literate to find the clues. Dentists are usually not... Apart from the fact that I find together with a worldwide growing movement of conscious people that we do not want to be drugged on that level. Water should be free of toxins. End of story.  Level with the freedom to choose not to be vaccinated with a cocktail full of toxins (do some research there and you will be surprised again!)

My suggestion for any concerned dental group or local council or government that love to govern: show that you are not a puppet on a string for the sugar and fluoride industry (in New Zealand the softdrink industry alone is worth 1.2 billion dollar or over $1000 a year per family)! Ban advertising for junk food and plan to introduce real high dosage refined sodium fluoride (or better magnesium phosphate) in all soft drinks and lollies. And then warn it is toxic in higher volumes. Then rise the tax on all soft drinks, lollies and sugar  at least four times to what it is now and use this money to subsidise regular check-ups including personal diet advice for the  parents of lower aged children. In Denmark and Scotland they have used this model to get beautiful results. Come on New Zealand, show some nr 8 wire sense!

What the 'York Review' on the fluoridation of drinking water really found

Originally released : 28 October 2003

A statement from the Centre for Reviews and Dissemination (CRD).

In 1999, the Department of Health commissioned CRD to conduct a systematic review into the efficacy and safety of the fluoridation of drinking water. The review specifically looked at the effects on dental caries/decay, social inequalities and any harmful effects. The review was published on the CRD Fluoridation Review website and in the BMJ in October 2000.

We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. As such, we urge interested parties to read the review conclusions in full.

We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.

What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.

This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.

An association with water fluoride and other adverse effects such as cancer, bone fracture and Down's syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.

The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.

Since the report was published in October 2000 there has been no other scientifically defensible review that would alter the findings of the York review. As emphasised in the report, only high-quality studies can fill in the gaps in knowledge about these and other aspects of fluoridation. Recourse to other evidence of a similar or lower level than that included in the York review, no matter how copious, cannot do this.

The full report is available via the CRD Fluoridation Review website.

http://www.fluoride-journal.com/98-31-2/312103.htm Page 1 of 11

FLUORIDE 31(2),

1998, pp 103-118

International Society for Fluoride Research

Table of Contents

WHY I CHANGED MY MIND ABOUT WATER FLUORIDATION

John Colquhoun* © 1997 University of Chicago Press

Former Advocate

To explain how I came to change my opinion about water fluoridation, I must go back to when I was an

ardent advocate of the procedure. I now realize that I had learned, in my training in dentistry, only one

side of the scientific controversy over fluoridation. I had been taught, and believed, that there was really

no scientific case against fluoridation, and that only misinformed lay people and a few crackpot

professionals were foolish enough to oppose it. I recall how, after I had been elected to a local

government in Auckland (New Zealand's largest city, where I practised dentistry for many years and

where I eventually became the Principal Dental Officer) I had fiercely — and, I now regret, rather

arrogantly — poured scorn on another Council member (a lay person who had heard and accepted the

case against fluoridation) and persuaded the Mayor and majority of my fellow councillors to agree to

fluoridation of our water supply.

A few years later, when I had become the city's Principal Dental Officer, I published a paper in the New

Zealand Dental Journal that reported how children's tooth decay had declined in the city following

fluoridation of its water, to which I attributed the decline, pointing out that the greatest benefit appeared

to be in low-income areas [1]. My duties as a public servant included supervision of the city's school

dental clinics, which were part of a national School Dental Service which provided regular six-monthly

dental treatment, with strictly enforced uniform diagnostic standards, to almost all (98 percent) school

children up to the age of 12 or 13 years. I thus had access to treatment records, and therefore tooth decay

rates, of virtually all the city's children. In the study I claimed that such treatment statistics "provide a

valid measure of the dental health of our child population" [1]. That claim was accepted by my

professional colleagues, and the study is cited in the official history of the New Zealand Dental

Association [2].

INFORMATION CONFIDED

I was so articulate and successful in my support of water fluoridation that my public service superiors in

our capital city, Wellington, approached me and asked me to make fluoridation the subject of a world

study tour in 1980 — after which I would become their expert on fluoridation and lead a campaign to

promote fluoridation in those parts of New Zealand which had resisted having fluoride put into their

drinking water.

Before I left on the tour my superiors confided to me that they were worried about some new evidence

which had become available: information they had collected on the amount of treatment children were

receiving in our school dental clinics seemed to show that tooth decay was declining just as much in

places in New Zealand where fluoride had not been added to the water supply. But they felt sure that,

when they had collected more detailed information, on all children (especially the oldest treated, 12-13

year age group) from all fluoridated and all nonfluoridated places [3] — information which they would

start to collect while was I away on my tour — it would reveal that the teeth were better in the

fluoridated places: not the 50 to 60 percent difference which we had always claimed resulted from

fluoridation, but a significant difference nonetheless. They thought that the decline in tooth decay in the

nonfluoridated places must have resulted from the use of fluoride toothpastes and fluoride supplements,

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and from fluoride applications to the children's teeth in dental clinics, which we had started at the same

time as fluoridation. Being a keen fluoridationist, I readily accepted their explanation. Previously, of

course, we had assured the public that the only really effective way to reduce tooth decay was to add

fluoride to the water supply.

WORLD STUDY TOUR

My world study tour took me to North America, Britain, Europe, Asia, and Australia [4]. In the United

States I discussed fluoridation with Ernest Newbrun in San Francisco, Brian Burt in Ann Arbor, dental

scientists and officials like John Small in Bethesda near Washington, DC, and others at the Centers for

Disease Control in Atlanta. I then proceeded to Britain, where I met Michael Lennon, John Beale,

Andrew Rugg-Gunn, and Neil Jenkins, as well as many other scientists and public health officials in

Britain and Europe. Although I visited only pro-fluoridation research centers and scientists, I came

across the same situation which concerned my superiors in New Zealand. Tooth decay was declining

without water fluoridation. Again I was assured, however, that more extensive and thorough surveys

would show that fluoridation was the most effective and efficient way to reduce tooth decay. Such largescale

surveys, on very large numbers of children, were nearing completion in the United States, and the

authorities conducting them promised to send me the results.

LESSON FROM HISTORY

I now realize that what my colleagues and I were doing was what the history of science shows all

professionals do when their pet theory is confronted by disconcerting new evidence: they bend over

backwards to explain away the new evidence. They try very hard to keep their theory intact — especially

so if their own professional reputations depend on maintaining that theory. (Some time after I graduated

in dentistry almost half a century ago, I also graduated in history studies, my special interest being the

history of science — which may partly explain my re-examination of the fluoridation theory ahead of

many of my fellow dentists.)

So I returned from my study tour reinforced in my pro-fluoridation beliefs by these reassurances from

fluoridationists around the world. I expounded these beliefs to my superiors, and was duly appointed

chairman of a national "Fluoridation Promotion Committee." I was instructed to inform the public, and

my fellow professionals, that water fluoridation resulted in better children's teeth, when compared with

places with no fluoridation.

Surprise: Teeth Better Without Fluoridation?

Before complying, I looked at the new dental statistics that had been collected while I was away for my

own Health District, Auckland. These were for all children attending school dental clinics — virtually

the entire child population of Auckland. To my surprise, they showed that fewer fillings had been

required in the nonfluoridated part of my district than in the fluoridated part. When I obtained the same

statistics from the districts to the north and south of mine — that is, from "Greater Auckland," which

contains a quarter of New Zealand's population — the picture was the same: tooth decay had declined,

but there was virtually no difference in tooth decay rates between the fluoridated and non fluoridated

places. In fact, teeth were slightly better in the nonfluoridated areas. I wondered why I had not been sent

the statistics for the rest of New Zealand. When I requested them, they were sent to me with a warning

that they were not to be made public. Those for 1981 showed that in most Health Districts the percentage

of 12- and 13-year-old children who were free of tooth decay - that is, had perfect teeth - was greater in

the non-fluoridated part of the district. Eventually the information was published [4].

Over the next few years these treatment statistics, collected for all children, showed that, when similar

fluoridated and non-fluoridated areas were compared, child dental health continued to be slightly better

in the non-fluoridated areas [5,6]. My professional colleagues, still strongly defensive of fluoridation,

now claimed that treatment statistics did not provide a valid measure of child dental health, thus

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reversing their previous acceptance of such a measure when it had appeared to support fluoridation.

I did not carry out the instruction to tell people that teeth were better in the fluoridated areas. Instead, I

wrote to my American colleagues and asked them for the results of the large-scale surveys they had

carried out there. I did not receive an answer. Some years later, Dr John Yiamouyiannis obtained the

results by then collected by resorting to the U.S. Freedom of Information Act, which compelled the

authorities to release them. The surveys showed that there is little or no differences in tooth decay rates

between fluoridated and nonfluoridated places throughout America [7]. Another publication using the

same database, apparently intended to counter that finding, reported that when a more precise

measurement of decay was used, a small benefit from fluoridation was shown (20 percent fewer decayed

tooth surfaces, which is really less than one cavity per child) [8]. Serious errors in that report,

acknowledged but not corrected, have been pointed out, including a lack of statistical analysis and a

failure to report the percentages of decay-free children in the fluoridated and nonfluoridated areas [7].

Other large-scale surveys from United States, from Missouri and Arizona, have since revealed the same

picture: no real benefit to teeth from fluoride in drinking water [9, 10]. For example, Professor Steelink

in Tucson, AZ, obtained information on the dental status of all schoolchildren – 26,000 of them – as well

as information on the fluoride content of Tucson water [10]. He found: "When we plotted the incidence

of tooth decay versus fluoride content in a child's neighborhood drinking water, a positive correlation

was revealed. In other words, the more fluoride a child drank, the more cavities appeared in the teeth"

[11].

From other lands — Australia, Britain, Canada, Sri Lanka, Greece, Malta, Spain, Hungary, and India — a

similar situation has been revealed: either little or no relation between water fluoride and tooth decay, or

a positive one (more fluoride, more decay) [12-17]. For example, over 30 years Professor Teotia and his

team in India have examined the teeth of some 400,000 children. They found that tooth decay increases

as fluoride intake increases. Tooth decay, they decided, results from a deficiency of calcium and an

excess of fluoride [17].

CAUSE OF DECLINE IN TOOTH DECAY

At first I thought, with my colleagues, that other uses of fluoride must have been the main cause of the

decline in tooth decay throughout the western world. But what came to worry me about that argument

was the fact that, in the nonfluoridated part of my city, where decay had also declined dramatically, very

few children used fluoride toothpaste, many had not received fluoride applications to their teeth, and

hardly any had been given fluoride tablets. So I obtained the national figures on tooth decay rates of

five-year-olds from our dental clinics which had served large numbers of these children from the 1930s

on [18]. They show that tooth decay had started to decline well before we had started to use fluorides

(Fig. 1). Also, the decline has continued after all children had received fluoride all their lives, so the

continuing decline could not be because of fluoride. The fewer figures available for older children are

consistent with the above pattern of decline [18]. So fluorides, while possibly contributing, could not be

the main cause of the reduction in tooth decay.

So what did cause this decline, which we find in most industrialized countries? I do not know the answer

for sure, but we do know that after the second world war there was a rise in the standard of living of

many people. In my country there has been a tremendous increase in the consumption of fresh fruit and

vegetables since the 1930s, assisted by the introduction of household refrigerators [19]. There has also

been an eightfold increase in the consumption per head of cheese, which we now know has anti-decay

properties [19, 20]. These nutritional changes, accompanied by a continuing decline in tooth decay,

started before the introduction of fluorides.

The influence of general nutrition in protection against tooth decay has been well described in the past

[21], but is largely ignored by the fluoride enthusiasts, who insist that fluorides have been the main

contributor to improved dental health. The increase in tooth decay in third-world countries, much of

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which has been attributed to worsening nutrition [22], lends support to the argument that improved

nutrition in developed countries contributed to improved dental health.

Flawed Studies

The studies showing little if any benefit from fluoridation have been published since 1980. Are there

contrary findings? Yes: many more studies, published in dental professional journals, claim that there is

a benefit to teeth from water fluoride. An example is a recent study from New Zealand [23], carried out

in the southernmost area of the country [23]. Throughout New Zealand there is a range of tooth decay

rates, from very high to very low, occurring in both fluoridated and nonfluoridated areas. The same

situation exists in other countries.

What the pro-fluoride academics at our dental school did was to select from that southern area four

communities: one nonfluoridated, two fluoridated, and another which had stopped fluoridation a few

years earlier. Although information on decay rates in all these areas was available to them, from the

school dental service, they chose for their study the one non-fluoridated community with the highest

decay rate and two fluoridated ones with low decay rates, and compared these with the recently stopped

fluoridated one, which happened to have medium decay rates (both before and after it had stopped

fluoridation). The teeth of randomly selected samples of children from each community were examined.

The chosen communities, of course, had not been randomly selected. The results, first published with

much publicity in the news media, showed over 50 percent less tooth decay in the fluoridated

communities, with the recently defluoridated town in a "middle" position (see left side of Fig. 2). When I

obtained the decay rates for all children in all the fluoridated and all the nonfluoridated areas in that part

of New Zealand, as well as the decay rates for all children in the recently defluoridated town, they

revealed that there are virtually no differences in tooth decay rates related to fluoridation (see right side

of Fig. 2).

When I confronted the authors with this information, they retorted that the results of their study were

consistent with other studies. And of course it is true that many similar studies have been published in

the dental professional literature. It is easy to see how the consistent results are obtained: an appropriate

selection of the communities being compared. There is another factor: most pro-fluoridation studies

(including this New Zealand one) were not "blind" — that is, the examiners knew which children

received fluoride and which did not. Diagnosis of tooth decay is a very subjective exercise, and most of

the examiners were keen fluoridationists, so it is easy to see how their bias could affect their results. It is

just not possible to find a blind fluoridation study in which the fluoridated and nonfluoridated

populations were similar and chosen randomly.

EARLY FLAWED STUDIES

One of the early fluoridation studies listed in the textbooks is a New Zealand one, the "Hastings

Fluoridation Experiment" (the term "experiment" was later dropped because the locals objected to being

experimented on) [24]. I obtained the Health Department's fluoridation files under my own country's

"Official Information" legislation. They revealed how a fluoridation trial can, in effect, be rigged [25].

The school dentists in the area of the experiment were instructed to change their method of diagnosing

tooth decay, so that they recorded much less decay after fluoridation began. Before the experiment they

had filled (and classified as "decayed") teeth with any small catch on the surface, before it had penetrated

the outer enamel layer.After the experiment began, they filled (and classified as "decayed") only teeth

with cavities which penetrated the outer enamel layer. It is easy to see why a sudden drop in the numbers

of "decayed and filled" teeth occurred. This change in method of diagnosis was not reported in any of

the published accounts of the experiment.

Another city, Napier, which was not fluoridated but had otherwise identical drinking water, was at first

included in the experiment as an "ideal control" — to show how tooth decay did not decline the same as

in fluoridated Hastings. But when tooth decay actually declined more in the non-fluoridated control city

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than in the fluoridated one, in spite of the instructions to find fewer cavities in the fluoridated one, the

control was dropped and the experiment proceeded with no control. (The claimed excuse was that a

previously unknown trace element, molybdenum, had been discovered in some of the soil of the control

city, making tooth decay levels there unusually low [26], but this excuse is not supported by available

information, from the files or elsewhere, on decay levels throughout New Zealand).

The initial sudden decline in tooth decay in the fluoridated city, plus the continuing decline which we

now know was occurring everywhere else in New Zealand, were claimed to prove the success of

fluoridation. These revelations from government files were published in the international environmental

journal, The Ecologist, and presented in 1987 at the 56th Congress of the Australian and New Zealand

Association for the Advancement of Science [27].

When I re-examined the classic fluoridation studies, which had been presented to me in the text books

during my training, I found, as others had before me, that they also contained serious flaws [28-30]. The

earliest set, which purported to show an inverse relationship between tooth decay prevalence and

naturally occurring water fluoride concentrations, are flawed mainly by their nonrandom methods of

selecting data. The later set, the "fluoridation trials" at Newburgh, Grand Rapids, Evanston, and

Brantford, display inadequate baselines, negligible statistical analysis, and especially a failure to

recognize large variations in tooth decay prevalence in the control communities. We really cannot know

whether or not some of the tooth decay reductions reported in those early studies were due to water

fluoride.

I do not believe that the selection and bias that apparently occurred was necessarily deliberate.

Enthusiasts for a theory can fool themselves very often, and persuade themselves and others that their

activities are genuinely scientific. I am also aware that, after 50 years of widespread acceptance and

endorsement of fluoridation, many scholars (including the reviewers of this essay) may find it difficult to

accept the claim that the original fluoridation studies were invalid. That is why some of us, who have

reached that conclusion, have submitted an invitation to examine and discuss new and old evidence "in

the hope that at least some kind of scholarly debate will ensue" [31].

However, whether or not the early studies were valid, new evidence strongly indicates that water

fluoridation today is of little if any value. Moreover, it is now widely conceded that the main action of

fluoride on teeth is a topical one (at the surface of the teeth), not a systemic one as previously thought,

so that there is negligible benefit from swallowing fluoride [32].

Harm from Fluoridation

The other kind of evidence which changed my mind was that of harm from fluoridation. We had always

assured the public that there was absolutely no possibility of any harm. We admitted that a small

percentage of children would have a slight mottling of their teeth, caused by the fluoride, but this

disturbance in the formation of tooth enamel would, we asserted, be very mild and was nothing to worry

about. It was, we asserted, not really a sign of toxicity (which was how the early literature on clinical

effects of fluoride had described it) but was only at most a slight, purely cosmetic change, and no threat

to health. In fact, we claimed that only an expert could ever detect it.

HARM TO TEETH

So it came as a shock to me when I discovered that in my own fluoridated city some children had teeth

like those in Fig. 3. This kind of mottling answered the description of dental fluorosis (bilateral diffuse

opacities along the growth lines of the enamel). Some of the children with these teeth had used fluoride

toothpaste and swallowed much of it. But I could not find children with this kind of fluorosis in the

nonfluoridated parts of my Health District, except in children who had been given fluoride tablets at the

recommended dose of that time.

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I published my findings: 25 percent of children had dental fluorosis in fluoridated Auckland and around

3 percent had the severer (discolored or pitted) degree of the condition [33]. At first the authorities

vigorously denied that fluoride was causing this unsightly mottling. However, the following year another

Auckland study, intended to discount my finding, reported almost identical prevalences and severity, and

recommended lowering the water fluoride level to below 1 ppm [34]. Others in New Zealand and the

United States have reported similar findings. All these studies were reviewed in the journal of the

International Society for Fluoride Research [35]. The same unhappy result of systemic administration of

fluoride has been reported in children who received fluoride supplements [36]. As a result, in New

Zealand as elsewhere, the doses of fluoride tablets were drastically reduced, and parents were warned to

reduce the amount of fluoride toothpaste used by their children, and to caution them not swallow any.

Fluoridationists would not at first admit that fluoridated water contributed to the unsightly mottling —

though later, in some countries including New Zealand, they also recommended lowering the level of

fluoride in the water. They still insist that the benefit to teeth outweighs any harm.

Figure 3. — Examples of dental fluorosis in 8- and 9-year old children

who grew up in fluoridated Auckland, New Zealand

WEAKENED BONES

Common sense should tell us that if a poison circulating in a child's body can damage the tooth-forming

cells, then other harm also is likely. We had always admitted that fluoride in excess can damage bones,

as well as teeth.

By 1983 I was thoroughly convinced that fluoridation caused more harm than good. I expressed the

opinion that some of these children with dental fluorosis could, just possibly, have also suffered harm to

their bones [Letter to Auckland Regional Authority, January 1984]. This opinion brought scorn and

derision: there was absolutely no evidence, my dental colleagues asserted, of any other harm from low

levels of fluoride intake, other than mottling of the teeth.

Six years later, the first study reporting an association between fluoridated water and hip fractures in the

elderly was published [37]. It was a large-scale one. Computerization has made possible the

accumulation of vast data banks of information on various diseases. Hip fracture rates have increased

dramatically, independently of the increasing age of populations. Seven other studies have now reported

this association between low water fluoride levels and hip fractures [38-44]. Have there been contrary

findings? Yes; but most of the studies claiming no association are of small numbers of cases, over short

periods of time, which one would not expect to show any association [45, 46]. Another, comparing a

fluoridated and a nonfluoridated Canadian community, also found an association in males but not in

females, which hardly proves there is no difference in all cases [47]. Our fluoridationists claim that the

studies which do show such an association are only epidemiological ones, not clinical ones, and so are

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not conclusive evidence.

But in addition to these epidemiological studies, clinical trials have demonstrated that when fluoride was

used in an attempt to treat osteoporosis (in the belief it strengthened bones), it actually caused more hip

fractures [48-52]. That is, when fluoride accumulates in bones, it weakens them. We have always known

that only around half of any fluoride we swallow is excreted in our urine; the rest accumulates in our

bones [53, 54]. But we believed that the accumulation would be insignificant at the low fluoride levels of

fluoridated water. However, researchers in Finland during the 1980s reported that people who lived 10

years or more in that country's one fluoridated city, Kuopio, had accumulated extremely high levels of

fluoride in their bones — thousands of parts per million — especially osteoporosis sufferers and people

with impaired kidney function [55, 56]. After this research was published, Finland stopped fluoridation

altogether. But that information has been ignored by our fluoridationists.

BONE CANCER?

An association with hip fracture is not the only evidence of harm to bones from fluoridation. Five years

ago, animal experiments were reported of a fluoride-related incidence of a rare bone cancer, called

osteosarcoma, in young male rats [57]. Why only the male animals got the bone cancer is not certain, but

another study has reported that fluoride at very low levels can interfere with the male hormone,

testosterone [58]. That hormone is involved in bone growth in males but not in females.

This finding was dismissed by fluoridation promoters as only "equivocal evidence," unlikely to be

important for humans. But it has now been found that the same rare bone cancer has increased

dramatically in young human males — teenage boys aged 9 to 19 — in the fluoridated areas of America

but not in the nonfluoridated areas [59]. The New Jersey Department of Health reported osteosarcoma

rates were three to seven times higher in its fluoridated areas than in its nonfluoridated areas [60].

Once again, our fluoridationists are claiming that this evidence does not "conclusively" demonstrate that

fluoride caused the cancers, and they cite small-scale studies indicating no association. One study

claimed that fluoride might even be protective against osteosarcoma [61]; yet it included only 42 males

in its 130 cases, which meant the cases were not typical of the disease, because osteosarcoma is routinely

found to be more common in males. Also, the case-control method used was quite inappropriate, being

based on an assumption that if ingested fluoride was the cause, osteosarcoma victims would require

higher fluoride exposure than those without the disease. The possibility that such victims might be more

susceptible to equal fluoride exposures was ignored. All these counter-claims have been subjected to

critical scrutiny which suggests they are flawed [62, 63]. Nonetheless, the pro-fluoride lobbyists

continue to insist that water fluoridation should continue because, in their view, the benefits to teeth

outweigh the possibility of harm. Many dispute that assessment.

OTHER EVIDENCE OF HARM

There is much more evidence that tooth mottling is not the only harm caused by fluoridated water. Polish

researchers, using a new computerized method of X-ray diagnosis, reported that boys with dental

fluorosis also exhibit bone structure disturbances [64]. Even more chilling is the evidence from China

that children with dental fluorosis have on average lower intelligence scores [65, 66]. This finding is

supported by a recently published animal experiment in America, which showed that fluoride also

accumulated in certain areas of the brain, affecting behavior and the ability to learn [67].

Endorsements Not Universal

Concerning the oft-repeated observation that fluoridation has enjoyed overwhelming scientific

endorsement, one should remember that even strongly supported theories have eventually been revised or

replaced. From the outset, distinguished and reputable scientists opposed fluoridation, in spite of

considerable intimidation and pressure [68, 69].

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Most of the world has rejected fluoridation. Only America where it originated, and countries under

strong American influence persist in the practice. Denmark banned fluoridation when its National

Agency for Environmental Protection, after consulting the widest possible range of scientific sources,

pointed out that the long-term effects of low fluoride intakes on certain groups in the population (for

example, persons with reduced kidney function), were insufficiently known [70]. Sweden also rejected

fluoridation on the recommendation of a special Fluoride Commission, which included among its reasons

that: "The combined and long-term environmental effects of fluoride are insufficiently known" [71].

Holland banned fluoridation after a group of medical practitioners presented evidence that it caused

reversible neuromuscular and gastrointestinal harm to some individuals in the population [72].

Environmental scientists, as well as many others, tend to doubt fluoridation. In the United States,

scientists employed by the Environmental Protection Agency have publicly disavowed support for their

employer's pro-fluoridation policies [73]. The orthodox medical establishment, rather weak or even

ignorant on environmental issues, persist in their support, as do most dentists, who tend to be almost

fanatical about the subject. In English- speaking countries, unfortunately, the medical profession and its

allied pharmaceutical lobby (the people who sell fluoride) seem to have more political influence than

environmentalists.

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fluoridation. Community Health Studies 14 288-296 1990.

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and non-fluoridated water areas of the Auckland Region. New Zealand Dental Journal 81 12-19

1985.

  1. Colquhoun J. Disfiguring or "white and strong"?Fluoride23 104-111 1990.
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permanent teeth. Archives of Oral Biology 19 321-326 1974.

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white women aged 65 years and older. Journal of the American Medical Association 264 500-502

1990.

  1. Cooper C, Wickham CAC, Barker DJR, Jacobsen SJ. Letter.Journal of the American Medical

Association 266 513-514 1991.

  1. Jacobsen SJ, Goldberg J, Cooper C, Lockwood SA. The association between water fluoridation

and hip fracture among white women and men aged 65 years and older. A national ecologic study.

Annals of Epidemiology 2 617-626 1992.

  1. Sowers MFR, Clark MK, Jannausch ML, Wallace RB. A prospective study of bone mineral

content and fracture in communities with differential fluoride exposure. American Journal of

Epidemiology 133 649-660 1991.

  1. Jacqmin-Gadda H, Commenges D, Dartigues J-F. Fluorine concentration in drinking water and

fractures in the elderly. Journal of the American Medical Association 273 775-776 1995.

  1. Danielson C, Lyon JL, Egger M, Goodenough GK. Hip fractures and fluoridation in Utah's elderly

population. Journal of the American Medical Association 268 746-748 1992.

  1. Keller C. Fluorides in drinking water. Paper presented at Workshop on Drinking Water Fluoride

Influence on Hip Fractures and Bone Health. Bethesda MD, April 10 1991.

  1. May DS., Wilson MG. Hip fractures in relation to water fluoridation: an ecologic analysis. Paper

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presented at Workshop on Drinking Water Fluoride Influence on Hip Fractures and Bone Health.

Bethesda MD, April 10, 1991.

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fluoridation prevent osteoporosis and its related fractures? American Journal of Epidemiology 134

768 1991. Abstract.

  1. Jacobsen SJ, O'Fallon WM, Melton III IJ. Hip fracture incidence before and after fluoridation of

the public water supply, Rochester, Minnesota. American Journal of Public Health 83 743-745

1993.

  1. Suarez-Almazor ME, Flowerdew G, Saunders LDet al.The fluoridation of drinking water and hip

fracture hospitalization rates in 2 Canadian communities. American Journal of Public Health 83

689-693 1993.

  1. Riggs BL, Hodgson SF, O'Fallon WMet al. Effect of fluoride treatment on the fracture rate in

postmenopausal women with osteoporosis. New England Journal of Medicine 322 802-809 1990.

  1. Kleerekoper M, Peterson E, Philips Eet al. Continuous sodium fluoride therapy does not reduce

vertebral fracture rate in postmenopausal osteoporosis. Journal of Bone and Mineral Research 4

(Suppl 1) S376 1989. Abstract.

  1. Hedlund LR, Gallagher JC. Increased incidence of hip fracture in osteoporotic women treated with

sodium fluoride. Journal of Bone and Mineral Research 4 223-225 1989.

  1. Lindsay R. Fluoride and bone - quantity versus quality.New England Journal of Medicine322

844-845 1990.

  1. Melton LJ. Fluoride in the prevention of osteoporosis and fractures.Journal of Bone and Mineral

Research 5 (Suppl 1) S163-S167 1990.

  1. 53Fluorides and Human Health.World Health Organization, Geneva 1970 pp 37-41.
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fluoride content, strength and mineral density of human bone. Acta Orthopædica Scandinavica 51

413-420 1980.

  1. Arnala I, Alhava EM, Kauranen EM. Effects of fluoride on bone in Finland. histomorphometry of

cadaver bone from low and high fluoride areas. Acta Orthopædica Scandinavica 56 161-166 1985.

  1. Maurer JK, Cheng MC, Boysen BG, Anderson RL. Two-year carcinogenicity study of sodium

fluoride in rats. Journal, National Cancer Institute 82 1118-1126 1990.

  1. Kanwar KC, Parminderjit SV, Kalla NR.In vitroinhibition of testosterone synthesis in the

presence of fluoride ions. IRCS Medical Science 11 813-814 1983.

  1. Hoover RN, Devesa S, Cantor K, Fraumeni Jr JF. Time trends for bone and joint cancers and

osteosarcomas in the Surveillance, Epidemiology and End Results (SEER) Program, National

Cancer Institute. In: Review of Fluoride: Benefits and Risks, Report of the Ad Hoc Committee on

Fluoride of the Committee to Coordinate Environmental Health and Related Programs. US Public

Health Service, 1991. F1-F7.

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osteosarcoma among young males. New Jersey Department of Health, November 8 1992.

  1. Gelberg KH, Fitzgerald EF, Hwang S, Dubrow R. Fluoride exposure and childhood osteosarcoma:

a case-control study. American Journal of Public Health 85 1678-1683 1995.

  1. Lee JR. Review of report by K H Gelberget al. Fluoride29 237-240 1996.
  2. Yiamouyiannis JA. Fluoridation and cancer.Fluoride26 83-96 1993.
  3. Chlebna-Sokol D, Czerwinski E. Bone structure assessment on radiographs of distal radial

metaphysis in children with dental fluorosis. Fluoride 26 37-44 1993.

  1. Li XS, Zhi JL, Gao RO. Effect of fluoride exposure on intelligence of children.Fluoride28 189-

192 1995.

  1. Zhao LB, Liang GH, Zhang DN, Wu XR. Effect of a high fluoride water supply on children's

intelligence. Fluoride 29 190-192 1996.

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Neurotoxicology and Teratology 17 169-177 1995 (Cf. Editorial: Neurotoxicity of Fluoride.

Fluoride 29 57-58 1996).

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  1. Martin B.Scientific Knowledge in Controversy: The Social Dynamics of the Fluoridation Debate.

State University of New York Press, Albany NY 1991.

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Press, Lawrence KS 1978. Chapter 18.

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Special issue (in English), February, 1977.

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Utredningar, Stockholm 1981. English-language summary pp 21-30.

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(preliminary report). Fluoride 7 146-152 1974.

  1. Hirzy W. Press releases.Fluoride26 279-281 1993; Fluoride 30 258-259 1997.

* John Colquhoun

School of Education, University of Auckland,

Private Bag 92019, Auckland, New Zealand.

© 1997 by The University of Chicago Press. All rights reserved.

First published in Perspectives in Biology and Medicine 41 29-44 1997

Reprinted with permission in Fluoride,

Journal of the International Society for Fluoride Research.

Editorial Office: 81A Landscape Road, Mount Eden, Auckland 1004, New Zealand

PERSPECTIVES IN BIOLOGY AND MEDICINE

The purpose of this quarterly journal is to serve as a vehicle for articles which convey new ideas or

stimulate original thought in the biological and medical sciences. Subscription information is available

from the publisher: the University of Chicago Press, Journals Division, PO Box 37005, Chicago, IL

60637, USA.

FLUORIDE 31 (2)

1998, 103-118

International Society for Fluoride Research

OPINION ON FLUORIDE by Dr. Fred M. Timmermans

"The best medicine in the world without any side effect is a smiling face" Rhisika Jane

I am and most New Zealand dentists are concerned about the rise of dental decay in New Zealand in mainly children. Unfortunately this is now a worldwide issue after a period of decline. In my opinion it is a socio-economic phenomenon that has happened before and will recover in time with real investment in good health education. But not by starting another water fluoridation war as DHB's and the Dental Associations are trying to do again in both the UK and NZ.

The essence is simple: decide upon this matter according to the precautionary principle. With so much conflicting evidence for fluoride, it can never be admitted in our water.

History repeats itself: we have seen this happening in the 1950's in Europe where people gained their first income growth out of the post war "poorness" and the first luxury they spend their money on was carbonated sugar water and lollies. This is now happening with the many Maori, Asian and Pacific islands immigrants in New Zealand but also to a considerable part of the NZ - European population with lower socio-economic status, as was the outcome of the 2009 New Zealand Oral Health Survey. The difference is that in the 1950's ninety-nine percent of current junkfood choices did not exist. I was shocked at my arrival in NZ in 2007 to see how much more advertising time TV NZ has compared to Europe, how aggressive this was promoting all the wrong food choices, promoting terrible pharmaceuticals and promoting constant spraying of pesticides around the house. So I full-heartedly support the petition initiative by a group of concerned parents to stop the media targeting children with junk advertising. Please sign up too for the petition here: http://www.actionstation.org.nz/stop-marketing-at-our-children. My question here is: can we as adults withstand all the temptation that is sprayed out of TV-sets every day? My opinion: BAN TELEVISION IN YOUR HOUSE FULLY! That is the best health choice you will ever make that will extend your life with decades and reduce your stress levels wonderfully!  The internet provides me with far more and better information then television can ever give and of course now and then you can chose a good movie on demand without the annoying ads.

BUT I DO NOT WANT WATER FLUORIDATION BECAUSE IT IS:

  • UNLOGICAL:  Less then 0.5% of tap water is used for drinking and this is far less for the group who needs it most, they get most drinks from bottles and then usually carbonated and carbohydrated (see my suggestions at the end of this opinion article)
  • UNECOLOGICAL: unwanted environmental loading of our waterways by unnatural toxic substance (a biocide waste product with contaminants very different from natural fluoride occurring in some natural ecosystems)
  • UNETHICAL: it is forced medication, which is almost impossible to remove or avoid
  • TOXICOLOGICALLY and physiologically strongly debatable: it is an untargeted form of medication which absolutely disregards actual individual intake requirements which can easily lead to a wrong individual dosage and affect many who do not need this at all. Example: most tea has natural NaF in it, drinking tea with fluoridated water will cause a higher then the advised 0.7 ppm concentration of fluoride. NZ is a tea drinking nation, so this is in my opinion unacceptable
  • UNACCEPTABLE politically in an open and free democracy (is this indirect proof of failing democracy in the US, about the only country that has lasting water fluoridation?) as is proven in all European countries where water fluoridation is  nearly non-existent. Most countries even filter the natural fluoride out as it is seen as an unwanted contaminant.
  • UNSCIENTIFIC: There is a war on fluoridation with very controversial research findings.  Conflict of interest taint nearly all medical/dental studies (see this alarming article from the editor of the New England Journal of Medicine). Nothing new really, already in 1965  Dr. G.L. Waldbott, M.D. wrote a very interesting review (you can download the whole book here) on the controversies and conflicts of interest he found in studies around the introduction of fluoridation. What he saw looked very similar to what John Colquhoun published in 1997 (full article below): your safety is not guaranteed! Other minerals in water or diet have a huge impact on our teeth as well, and can compromise the influence of fluoridation as was found when Hastings was compared with non fluoridated Napier: Napier had better teeth and still has 50 years later! This might have to do with the occurrence of Molybdenum traces in Napiers water (Link here).
  • In 1961 D.B. Richie from the university of Otago found that a group of 200 patients who had been supplemented for three years with Magnesium Phosphate had far better teeth compared with non supplemented patients (Nature, April 1961 p456-458) No one ever did follow up on this research, while it promised a great and SAFE alternative to fluoridation... Our practice advises many patients supplements with Magnesium, there is more research proving it to be preventative for gum health too and since it is often depleted in NZ soil, the presence in our food is fully dependent on the farmer using fertiliser with added Magnesium (which is not guaranteed...)
  • Fact is that the hydrofluorosilic acid used for water fluoridation is now labelled as a carcinogenic neurotoxin and was in use as a biocide.  Biocide manufactures since (only) 2007 have to prove that they are not dangerous for humans, hydrofluorosic acid was banned in Europe because no manufacturer dared to do this research (see link). But strange as it may sound for use in our drinking water this rule does not apply... So in essence it is one big chemical experiment with a very questionable substance which is a problem waste product from the fertiliser industry. Most of the time it does not even undergo purification and then has various contaminants especially arsenic. But Fluoride is not the only danger. Every year more new chemical formulas come on the market without any or minimal research on toxicity. It is in our food and many household products as toothpaste, soaps and shampoos and also in fillings! It is a horrifying brew we are in thanks to the chemical industry...

It is so simple to create a healthy mouth without any toxic additives in our water or toothpaste! Why does the profession so underestimate the effect that we can have with diet change advise that can create health and is an unique chance to prevent much more than just cavities? Fluoridation is  another attempt to disguise our disconnection from nature and healthy food. We are being slowly poisoned by the combined effect of environmental pollution and the never ending seduction for cheap carbohydrate rich, but empty food that the processed food industry offers us. Obesity and diabetes are absolutely not being cured by fluoridation, neither have I ever seen any real dental health effect from fluoride with persons who did not change their sugar rich carbo - lust diets. It is known since Weston Price did his fieldwork: as soon as our western diet (sugar, corn, wheat and alcohol) was introduced in newly acquired colonies, tooth decay became a problem. As it is also known that better educated and higher income populations have far less decay. They have learned to go back to cooking and growing their own slow food that was once the main course of the "non" civilised world.

Below is the conclusive evidence from the UK that fluoride does not have the qualities that we are usually been told and then a personal opinion from a dentist in Auckland about why he has changed his opinion on fluoride: most of the research is absolute junk science sponsored by the industry and/or the wanted outcome is created by selective data use by the researcher. I found a nice example of this done by the frequently quoted US Centre for Disease Control: compare the official York review below with the conclusions that the CDC quotes from this very same review (see this page: http://www.cdc.gov/fluoridation/safety/systematic.htm). They call this page systematic assessing the weight of evidence! Systematic lying? Not ONE word over the absolute lack of quality of the research itself. This is Modern Science. Welcome to a world of money and fraud. Recently: the 2009 New Zealand Oral Health Survey. Now in full use to promote fluoridation. Read the quote on this page: " the study was not designed as an in depth waterfluoridation study": yes we just keep doing it.....

And the junk science war has still not come to an end, one must be very literate to find the clues. Dentists are usually not... Apart from the fact that I find together with a worldwide growing movement of conscious people that we do not want to be drugged on that level. Water should be free of toxins. End of story.  Level with the freedom to choose not to be vaccinated with a cocktail full of toxins (do some research there and you will be surprised again!)

My suggestion for any concerned dental group or local council or government that love to govern: show that you are not a puppet on a string for the sugar and fluoride industry (in New Zealand the softdrink industry alone is worth 1.2 billion dollar or over $1000 a year per family)! Ban advertising for junk food and plan to introduce real high dosage refined sodium fluoride (or better magnesium phosphate) in all soft drinks and lollies. And then warn it is toxic in higher volumes. Then rise the tax on all soft drinks, lollies and sugar  at least four times to what it is now and use this money to subsidise regular check-ups including personal diet advice for the  parents of lower aged children. In Denmark and Scotland they have used this model to get beautiful results. Come on New Zealand, show some nr 8 wire sense!

What the 'York Review' on the fluoridation of drinking water really found

Originally released : 28 October 2003

A statement from the Centre for Reviews and Dissemination (CRD).

In 1999, the Department of Health commissioned CRD to conduct a systematic review into the efficacy and safety of the fluoridation of drinking water. The review specifically looked at the effects on dental caries/decay, social inequalities and any harmful effects. The review was published on the CRD Fluoridation Review website and in the BMJ in October 2000.

We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. As such, we urge interested parties to read the review conclusions in full.

We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.

What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.

This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.

An association with water fluoride and other adverse effects such as cancer, bone fracture and Down's syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.

The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.

Since the report was published in October 2000 there has been no other scientifically defensible review that would alter the findings of the York review. As emphasised in the report, only high-quality studies can fill in the gaps in knowledge about these and other aspects of fluoridation. Recourse to other evidence of a similar or lower level than that included in the York review, no matter how copious, cannot do this.

The full report is available via the CRD Fluoridation Review website.

http://www.fluoride-journal.com/98-31-2/312103.htm Page 1 of 11

FLUORIDE 31(2),

1998, pp 103-118

International Society for Fluoride Research

Table of Contents

WHY I CHANGED MY MIND ABOUT WATER FLUORIDATION

John Colquhoun* © 1997 University of Chicago Press

Former Advocate

To explain how I came to change my opinion about water fluoridation, I must go back to when I was an

ardent advocate of the procedure. I now realize that I had learned, in my training in dentistry, only one

side of the scientific controversy over fluoridation. I had been taught, and believed, that there was really

no scientific case against fluoridation, and that only misinformed lay people and a few crackpot

professionals were foolish enough to oppose it. I recall how, after I had been elected to a local

government in Auckland (New Zealand's largest city, where I practised dentistry for many years and

where I eventually became the Principal Dental Officer) I had fiercely — and, I now regret, rather

arrogantly — poured scorn on another Council member (a lay person who had heard and accepted the

case against fluoridation) and persuaded the Mayor and majority of my fellow councillors to agree to

fluoridation of our water supply.

A few years later, when I had become the city's Principal Dental Officer, I published a paper in the New

Zealand Dental Journal that reported how children's tooth decay had declined in the city following

fluoridation of its water, to which I attributed the decline, pointing out that the greatest benefit appeared

to be in low-income areas [1]. My duties as a public servant included supervision of the city's school

dental clinics, which were part of a national School Dental Service which provided regular six-monthly

dental treatment, with strictly enforced uniform diagnostic standards, to almost all (98 percent) school

children up to the age of 12 or 13 years. I thus had access to treatment records, and therefore tooth decay

rates, of virtually all the city's children. In the study I claimed that such treatment statistics "provide a

valid measure of the dental health of our child population" [1]. That claim was accepted by my

professional colleagues, and the study is cited in the official history of the New Zealand Dental

Association [2].

INFORMATION CONFIDED

I was so articulate and successful in my support of water fluoridation that my public service superiors in

our capital city, Wellington, approached me and asked me to make fluoridation the subject of a world

study tour in 1980 — after which I would become their expert on fluoridation and lead a campaign to

promote fluoridation in those parts of New Zealand which had resisted having fluoride put into their

drinking water.

Before I left on the tour my superiors confided to me that they were worried about some new evidence

which had become available: information they had collected on the amount of treatment children were

receiving in our school dental clinics seemed to show that tooth decay was declining just as much in

places in New Zealand where fluoride had not been added to the water supply. But they felt sure that,

when they had collected more detailed information, on all children (especially the oldest treated, 12-13

year age group) from all fluoridated and all nonfluoridated places [3] — information which they would

start to collect while was I away on my tour — it would reveal that the teeth were better in the

fluoridated places: not the 50 to 60 percent difference which we had always claimed resulted from

fluoridation, but a significant difference nonetheless. They thought that the decline in tooth decay in the

nonfluoridated places must have resulted from the use of fluoride toothpastes and fluoride supplements,

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and from fluoride applications to the children's teeth in dental clinics, which we had started at the same

time as fluoridation. Being a keen fluoridationist, I readily accepted their explanation. Previously, of

course, we had assured the public that the only really effective way to reduce tooth decay was to add

fluoride to the water supply.

WORLD STUDY TOUR

My world study tour took me to North America, Britain, Europe, Asia, and Australia [4]. In the United

States I discussed fluoridation with Ernest Newbrun in San Francisco, Brian Burt in Ann Arbor, dental

scientists and officials like John Small in Bethesda near Washington, DC, and others at the Centers for

Disease Control in Atlanta. I then proceeded to Britain, where I met Michael Lennon, John Beale,

Andrew Rugg-Gunn, and Neil Jenkins, as well as many other scientists and public health officials in

Britain and Europe. Although I visited only pro-fluoridation research centers and scientists, I came

across the same situation which concerned my superiors in New Zealand. Tooth decay was declining

without water fluoridation. Again I was assured, however, that more extensive and thorough surveys

would show that fluoridation was the most effective and efficient way to reduce tooth decay. Such largescale

surveys, on very large numbers of children, were nearing completion in the United States, and the

authorities conducting them promised to send me the results.

LESSON FROM HISTORY

I now realize that what my colleagues and I were doing was what the history of science shows all

professionals do when their pet theory is confronted by disconcerting new evidence: they bend over

backwards to explain away the new evidence. They try very hard to keep their theory intact — especially

so if their own professional reputations depend on maintaining that theory. (Some time after I graduated

in dentistry almost half a century ago, I also graduated in history studies, my special interest being the

history of science — which may partly explain my re-examination of the fluoridation theory ahead of

many of my fellow dentists.)

So I returned from my study tour reinforced in my pro-fluoridation beliefs by these reassurances from

fluoridationists around the world. I expounded these beliefs to my superiors, and was duly appointed

chairman of a national "Fluoridation Promotion Committee." I was instructed to inform the public, and

my fellow professionals, that water fluoridation resulted in better children's teeth, when compared with

places with no fluoridation.

Surprise: Teeth Better Without Fluoridation?

Before complying, I looked at the new dental statistics that had been collected while I was away for my

own Health District, Auckland. These were for all children attending school dental clinics — virtually

the entire child population of Auckland. To my surprise, they showed that fewer fillings had been

required in the nonfluoridated part of my district than in the fluoridated part. When I obtained the same

statistics from the districts to the north and south of mine — that is, from "Greater Auckland," which

contains a quarter of New Zealand's population — the picture was the same: tooth decay had declined,

but there was virtually no difference in tooth decay rates between the fluoridated and non fluoridated

places. In fact, teeth were slightly better in the nonfluoridated areas. I wondered why I had not been sent

the statistics for the rest of New Zealand. When I requested them, they were sent to me with a warning

that they were not to be made public. Those for 1981 showed that in most Health Districts the percentage

of 12- and 13-year-old children who were free of tooth decay - that is, had perfect teeth - was greater in

the non-fluoridated part of the district. Eventually the information was published [4].

Over the next few years these treatment statistics, collected for all children, showed that, when similar

fluoridated and non-fluoridated areas were compared, child dental health continued to be slightly better

in the non-fluoridated areas [5,6]. My professional colleagues, still strongly defensive of fluoridation,

now claimed that treatment statistics did not provide a valid measure of child dental health, thus

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reversing their previous acceptance of such a measure when it had appeared to support fluoridation.

I did not carry out the instruction to tell people that teeth were better in the fluoridated areas. Instead, I

wrote to my American colleagues and asked them for the results of the large-scale surveys they had

carried out there. I did not receive an answer. Some years later, Dr John Yiamouyiannis obtained the

results by then collected by resorting to the U.S. Freedom of Information Act, which compelled the

authorities to release them. The surveys showed that there is little or no differences in tooth decay rates

between fluoridated and nonfluoridated places throughout America [7]. Another publication using the

same database, apparently intended to counter that finding, reported that when a more precise

measurement of decay was used, a small benefit from fluoridation was shown (20 percent fewer decayed

tooth surfaces, which is really less than one cavity per child) [8]. Serious errors in that report,

acknowledged but not corrected, have been pointed out, including a lack of statistical analysis and a

failure to report the percentages of decay-free children in the fluoridated and nonfluoridated areas [7].

Other large-scale surveys from United States, from Missouri and Arizona, have since revealed the same

picture: no real benefit to teeth from fluoride in drinking water [9, 10]. For example, Professor Steelink

in Tucson, AZ, obtained information on the dental status of all schoolchildren – 26,000 of them – as well

as information on the fluoride content of Tucson water [10]. He found: "When we plotted the incidence

of tooth decay versus fluoride content in a child's neighborhood drinking water, a positive correlation

was revealed. In other words, the more fluoride a child drank, the more cavities appeared in the teeth"

[11].

From other lands — Australia, Britain, Canada, Sri Lanka, Greece, Malta, Spain, Hungary, and India — a

similar situation has been revealed: either little or no relation between water fluoride and tooth decay, or

a positive one (more fluoride, more decay) [12-17]. For example, over 30 years Professor Teotia and his

team in India have examined the teeth of some 400,000 children. They found that tooth decay increases

as fluoride intake increases. Tooth decay, they decided, results from a deficiency of calcium and an

excess of fluoride [17].

CAUSE OF DECLINE IN TOOTH DECAY

At first I thought, with my colleagues, that other uses of fluoride must have been the main cause of the

decline in tooth decay throughout the western world. But what came to worry me about that argument

was the fact that, in the nonfluoridated part of my city, where decay had also declined dramatically, very

few children used fluoride toothpaste, many had not received fluoride applications to their teeth, and

hardly any had been given fluoride tablets. So I obtained the national figures on tooth decay rates of

five-year-olds from our dental clinics which had served large numbers of these children from the 1930s

on [18]. They show that tooth decay had started to decline well before we had started to use fluorides

(Fig. 1). Also, the decline has continued after all children had received fluoride all their lives, so the

continuing decline could not be because of fluoride. The fewer figures available for older children are

consistent with the above pattern of decline [18]. So fluorides, while possibly contributing, could not be

the main cause of the reduction in tooth decay.

So what did cause this decline, which we find in most industrialized countries? I do not know the answer

for sure, but we do know that after the second world war there was a rise in the standard of living of

many people. In my country there has been a tremendous increase in the consumption of fresh fruit and

vegetables since the 1930s, assisted by the introduction of household refrigerators [19]. There has also

been an eightfold increase in the consumption per head of cheese, which we now know has anti-decay

properties [19, 20]. These nutritional changes, accompanied by a continuing decline in tooth decay,

started before the introduction of fluorides.

The influence of general nutrition in protection against tooth decay has been well described in the past

[21], but is largely ignored by the fluoride enthusiasts, who insist that fluorides have been the main

contributor to improved dental health. The increase in tooth decay in third-world countries, much of

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which has been attributed to worsening nutrition [22], lends support to the argument that improved

nutrition in developed countries contributed to improved dental health.

Flawed Studies

The studies showing little if any benefit from fluoridation have been published since 1980. Are there

contrary findings? Yes: many more studies, published in dental professional journals, claim that there is

a benefit to teeth from water fluoride. An example is a recent study from New Zealand [23], carried out

in the southernmost area of the country [23]. Throughout New Zealand there is a range of tooth decay

rates, from very high to very low, occurring in both fluoridated and nonfluoridated areas. The same

situation exists in other countries.

What the pro-fluoride academics at our dental school did was to select from that southern area four

communities: one nonfluoridated, two fluoridated, and another which had stopped fluoridation a few

years earlier. Although information on decay rates in all these areas was available to them, from the

school dental service, they chose for their study the one non-fluoridated community with the highest

decay rate and two fluoridated ones with low decay rates, and compared these with the recently stopped

fluoridated one, which happened to have medium decay rates (both before and after it had stopped

fluoridation). The teeth of randomly selected samples of children from each community were examined.

The chosen communities, of course, had not been randomly selected. The results, first published with

much publicity in the news media, showed over 50 percent less tooth decay in the fluoridated

communities, with the recently defluoridated town in a "middle" position (see left side of Fig. 2). When I

obtained the decay rates for all children in all the fluoridated and all the nonfluoridated areas in that part

of New Zealand, as well as the decay rates for all children in the recently defluoridated town, they

revealed that there are virtually no differences in tooth decay rates related to fluoridation (see right side

of Fig. 2).

When I confronted the authors with this information, they retorted that the results of their study were

consistent with other studies. And of course it is true that many similar studies have been published in

the dental professional literature. It is easy to see how the consistent results are obtained: an appropriate

selection of the communities being compared. There is another factor: most pro-fluoridation studies

(including this New Zealand one) were not "blind" — that is, the examiners knew which children

received fluoride and which did not. Diagnosis of tooth decay is a very subjective exercise, and most of

the examiners were keen fluoridationists, so it is easy to see how their bias could affect their results. It is

just not possible to find a blind fluoridation study in which the fluoridated and nonfluoridated

populations were similar and chosen randomly.

EARLY FLAWED STUDIES

One of the early fluoridation studies listed in the textbooks is a New Zealand one, the "Hastings

Fluoridation Experiment" (the term "experiment" was later dropped because the locals objected to being

experimented on) [24]. I obtained the Health Department's fluoridation files under my own country's

"Official Information" legislation. They revealed how a fluoridation trial can, in effect, be rigged [25].

The school dentists in the area of the experiment were instructed to change their method of diagnosing

tooth decay, so that they recorded much less decay after fluoridation began. Before the experiment they

had filled (and classified as "decayed") teeth with any small catch on the surface, before it had penetrated

the outer enamel layer.After the experiment began, they filled (and classified as "decayed") only teeth

with cavities which penetrated the outer enamel layer. It is easy to see why a sudden drop in the numbers

of "decayed and filled" teeth occurred. This change in method of diagnosis was not reported in any of

the published accounts of the experiment.

Another city, Napier, which was not fluoridated but had otherwise identical drinking water, was at first

included in the experiment as an "ideal control" — to show how tooth decay did not decline the same as

in fluoridated Hastings. But when tooth decay actually declined more in the non-fluoridated control city

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than in the fluoridated one, in spite of the instructions to find fewer cavities in the fluoridated one, the

control was dropped and the experiment proceeded with no control. (The claimed excuse was that a

previously unknown trace element, molybdenum, had been discovered in some of the soil of the control

city, making tooth decay levels there unusually low [26], but this excuse is not supported by available

information, from the files or elsewhere, on decay levels throughout New Zealand).

The initial sudden decline in tooth decay in the fluoridated city, plus the continuing decline which we

now know was occurring everywhere else in New Zealand, were claimed to prove the success of

fluoridation. These revelations from government files were published in the international environmental

journal, The Ecologist, and presented in 1987 at the 56th Congress of the Australian and New Zealand

Association for the Advancement of Science [27].

When I re-examined the classic fluoridation studies, which had been presented to me in the text books

during my training, I found, as others had before me, that they also contained serious flaws [28-30]. The

earliest set, which purported to show an inverse relationship between tooth decay prevalence and

naturally occurring water fluoride concentrations, are flawed mainly by their nonrandom methods of

selecting data. The later set, the "fluoridation trials" at Newburgh, Grand Rapids, Evanston, and

Brantford, display inadequate baselines, negligible statistical analysis, and especially a failure to

recognize large variations in tooth decay prevalence in the control communities. We really cannot know

whether or not some of the tooth decay reductions reported in those early studies were due to water

fluoride.

I do not believe that the selection and bias that apparently occurred was necessarily deliberate.

Enthusiasts for a theory can fool themselves very often, and persuade themselves and others that their

activities are genuinely scientific. I am also aware that, after 50 years of widespread acceptance and

endorsement of fluoridation, many scholars (including the reviewers of this essay) may find it difficult to

accept the claim that the original fluoridation studies were invalid. That is why some of us, who have

reached that conclusion, have submitted an invitation to examine and discuss new and old evidence "in

the hope that at least some kind of scholarly debate will ensue" [31].

However, whether or not the early studies were valid, new evidence strongly indicates that water

fluoridation today is of little if any value. Moreover, it is now widely conceded that the main action of

fluoride on teeth is a topical one (at the surface of the teeth), not a systemic one as previously thought,

so that there is negligible benefit from swallowing fluoride [32].

Harm from Fluoridation

The other kind of evidence which changed my mind was that of harm from fluoridation. We had always

assured the public that there was absolutely no possibility of any harm. We admitted that a small

percentage of children would have a slight mottling of their teeth, caused by the fluoride, but this

disturbance in the formation of tooth enamel would, we asserted, be very mild and was nothing to worry

about. It was, we asserted, not really a sign of toxicity (which was how the early literature on clinical

effects of fluoride had described it) but was only at most a slight, purely cosmetic change, and no threat

to health. In fact, we claimed that only an expert could ever detect it.

HARM TO TEETH

So it came as a shock to me when I discovered that in my own fluoridated city some children had teeth

like those in Fig. 3. This kind of mottling answered the description of dental fluorosis (bilateral diffuse

opacities along the growth lines of the enamel). Some of the children with these teeth had used fluoride

toothpaste and swallowed much of it. But I could not find children with this kind of fluorosis in the

nonfluoridated parts of my Health District, except in children who had been given fluoride tablets at the

recommended dose of that time.

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I published my findings: 25 percent of children had dental fluorosis in fluoridated Auckland and around

3 percent had the severer (discolored or pitted) degree of the condition [33]. At first the authorities

vigorously denied that fluoride was causing this unsightly mottling. However, the following year another

Auckland study, intended to discount my finding, reported almost identical prevalences and severity, and

recommended lowering the water fluoride level to below 1 ppm [34]. Others in New Zealand and the

United States have reported similar findings. All these studies were reviewed in the journal of the

International Society for Fluoride Research [35]. The same unhappy result of systemic administration of

fluoride has been reported in children who received fluoride supplements [36]. As a result, in New

Zealand as elsewhere, the doses of fluoride tablets were drastically reduced, and parents were warned to

reduce the amount of fluoride toothpaste used by their children, and to caution them not swallow any.

Fluoridationists would not at first admit that fluoridated water contributed to the unsightly mottling —

though later, in some countries including New Zealand, they also recommended lowering the level of

fluoride in the water. They still insist that the benefit to teeth outweighs any harm.

Figure 3. — Examples of dental fluorosis in 8- and 9-year old children

who grew up in fluoridated Auckland, New Zealand

WEAKENED BONES

Common sense should tell us that if a poison circulating in a child's body can damage the tooth-forming

cells, then other harm also is likely. We had always admitted that fluoride in excess can damage bones,

as well as teeth.

By 1983 I was thoroughly convinced that fluoridation caused more harm than good. I expressed the

opinion that some of these children with dental fluorosis could, just possibly, have also suffered harm to

their bones [Letter to Auckland Regional Authority, January 1984]. This opinion brought scorn and

derision: there was absolutely no evidence, my dental colleagues asserted, of any other harm from low

levels of fluoride intake, other than mottling of the teeth.

Six years later, the first study reporting an association between fluoridated water and hip fractures in the

elderly was published [37]. It was a large-scale one. Computerization has made possible the

accumulation of vast data banks of information on various diseases. Hip fracture rates have increased

dramatically, independently of the increasing age of populations. Seven other studies have now reported

this association between low water fluoride levels and hip fractures [38-44]. Have there been contrary

findings? Yes; but most of the studies claiming no association are of small numbers of cases, over short

periods of time, which one would not expect to show any association [45, 46]. Another, comparing a

fluoridated and a nonfluoridated Canadian community, also found an association in males but not in

females, which hardly proves there is no difference in all cases [47]. Our fluoridationists claim that the

studies which do show such an association are only epidemiological ones, not clinical ones, and so are

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not conclusive evidence.

But in addition to these epidemiological studies, clinical trials have demonstrated that when fluoride was

used in an attempt to treat osteoporosis (in the belief it strengthened bones), it actually caused more hip

fractures [48-52]. That is, when fluoride accumulates in bones, it weakens them. We have always known

that only around half of any fluoride we swallow is excreted in our urine; the rest accumulates in our

bones [53, 54]. But we believed that the accumulation would be insignificant at the low fluoride levels of

fluoridated water. However, researchers in Finland during the 1980s reported that people who lived 10

years or more in that country's one fluoridated city, Kuopio, had accumulated extremely high levels of

fluoride in their bones — thousands of parts per million — especially osteoporosis sufferers and people

with impaired kidney function [55, 56]. After this research was published, Finland stopped fluoridation

altogether. But that information has been ignored by our fluoridationists.

BONE CANCER?

An association with hip fracture is not the only evidence of harm to bones from fluoridation. Five years

ago, animal experiments were reported of a fluoride-related incidence of a rare bone cancer, called

osteosarcoma, in young male rats [57]. Why only the male animals got the bone cancer is not certain, but

another study has reported that fluoride at very low levels can interfere with the male hormone,

testosterone [58]. That hormone is involved in bone growth in males but not in females.

This finding was dismissed by fluoridation promoters as only "equivocal evidence," unlikely to be

important for humans. But it has now been found that the same rare bone cancer has increased

dramatically in young human males — teenage boys aged 9 to 19 — in the fluoridated areas of America

but not in the nonfluoridated areas [59]. The New Jersey Department of Health reported osteosarcoma

rates were three to seven times higher in its fluoridated areas than in its nonfluoridated areas [60].

Once again, our fluoridationists are claiming that this evidence does not "conclusively" demonstrate that

fluoride caused the cancers, and they cite small-scale studies indicating no association. One study

claimed that fluoride might even be protective against osteosarcoma [61]; yet it included only 42 males

in its 130 cases, which meant the cases were not typical of the disease, because osteosarcoma is routinely

found to be more common in males. Also, the case-control method used was quite inappropriate, being

based on an assumption that if ingested fluoride was the cause, osteosarcoma victims would require

higher fluoride exposure than those without the disease. The possibility that such victims might be more

susceptible to equal fluoride exposures was ignored. All these counter-claims have been subjected to

critical scrutiny which suggests they are flawed [62, 63]. Nonetheless, the pro-fluoride lobbyists

continue to insist that water fluoridation should continue because, in their view, the benefits to teeth

outweigh the possibility of harm. Many dispute that assessment.

OTHER EVIDENCE OF HARM

There is much more evidence that tooth mottling is not the only harm caused by fluoridated water. Polish

researchers, using a new computerized method of X-ray diagnosis, reported that boys with dental

fluorosis also exhibit bone structure disturbances [64]. Even more chilling is the evidence from China

that children with dental fluorosis have on average lower intelligence scores [65, 66]. This finding is

supported by a recently published animal experiment in America, which showed that fluoride also

accumulated in certain areas of the brain, affecting behavior and the ability to learn [67].

Endorsements Not Universal

Concerning the oft-repeated observation that fluoridation has enjoyed overwhelming scientific

endorsement, one should remember that even strongly supported theories have eventually been revised or

replaced. From the outset, distinguished and reputable scientists opposed fluoridation, in spite of

considerable intimidation and pressure [68, 69].

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Most of the world has rejected fluoridation. Only America where it originated, and countries under

strong American influence persist in the practice. Denmark banned fluoridation when its National

Agency for Environmental Protection, after consulting the widest possible range of scientific sources,

pointed out that the long-term effects of low fluoride intakes on certain groups in the population (for

example, persons with reduced kidney function), were insufficiently known [70]. Sweden also rejected

fluoridation on the recommendation of a special Fluoride Commission, which included among its reasons

that: "The combined and long-term environmental effects of fluoride are insufficiently known" [71].

Holland banned fluoridation after a group of medical practitioners presented evidence that it caused

reversible neuromuscular and gastrointestinal harm to some individuals in the population [72].

Environmental scientists, as well as many others, tend to doubt fluoridation. In the United States,

scientists employed by the Environmental Protection Agency have publicly disavowed support for their

employer's pro-fluoridation policies [73]. The orthodox medical establishment, rather weak or even

ignorant on environmental issues, persist in their support, as do most dentists, who tend to be almost

fanatical about the subject. In English- speaking countries, unfortunately, the medical profession and its

allied pharmaceutical lobby (the people who sell fluoride) seem to have more political influence than

environmentalists.

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* John Colquhoun

School of Education, University of Auckland,

Private Bag 92019, Auckland, New Zealand.

© 1997 by The University of Chicago Press. All rights reserved.

First published in Perspectives in Biology and Medicine 41 29-44 1997

Reprinted with permission in Fluoride,

Journal of the International Society for Fluoride Research.

Editorial Office: 81A Landscape Road, Mount Eden, Auckland 1004, New Zealand

PERSPECTIVES IN BIOLOGY AND MEDICINE

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FLUORIDE 31 (2)

1998, 103-118

International Society for Fluoride Research