David, I believe Carol may have been referring to the data on
fluoridation and tooth decay. Most of the studies have been very poorly
done--many of the older studies wouldn't pass through the gates of
peer-review today. And the data bank is hardly "enormous" as you claim.
When you accuse somebody of having "limited knowledge of the literature",
please make sure yours is up to{*filter*}and that you are not comparing
apples to oranges.

I prefer to read the actual articles or scientific studies rather than
the abstracts. If you draw conclusions based on a bunch of abstracts
(especially some of the reviews) without reading the literature, your
conclusions could well be erroneous (Brian Sandle does a lot of this).  
So how many studies have you read?

                        At first glance, yes!!

First, it appears that Carol may be talking about fluoride products
(i.e., "fluoride users") rather than fluoridation and you bring in
fluoridation studies as proof that Carol's statement is false (see
Tijmstra T. et al. below). Did I miss something here or am I
misinterpreting?

Second, the British Dental Journal (3 Anglesey abstracts you provide) is
not known for its objective analysis on either the fluoridation issue or
the amalgam issue. BDJ is a trade publication like JADA, not a scientific
journal.

Third, did you notice that if you went just from one of the Anglesey
abstracts, Thomas FD., et al., there was NO statistical significance
noted (no confidence level, no P values)? Did you also notice that the
differences in dmft were small? -- mean 2.01 dmft for the entire sample
(n=725); 1.81 for those who experienced fluoridation for 35% of their
lives (n=230); and, 2.28 for those who were exposed to fluoridation for
10% of their lives (n=268).

I admit that I haven't read this study but just based on the abstract, it
seems like this is hardly a testament to the "serious consequences for
dental health when fluoridation is withdrawn" (according to the authors),
since these small differences could be due to a combination of examiner
variation, socioeconomic differences, diet, toothbrushing habits,
frequency of dental care, inadequate sampling size, etc.
Did you also notice that the children who were examined in 1993 were BORN
in 1988, one year after fluoridation became intermittent? How in the
blazes could the authors determine which child had a 10 or 35%
fluoridation exposure? In other words, how can intermittent water
fluoridation possibly give accurate fluoride exposure percentages for a
child??  Is this a good study for you?

Fourth, you ask Carol below for "properly done" studies with controls for
all background variables, yet I see no such evidence for this in the
abstract that you pulled on fluoridation in Anglesey (haven't read the
others yet). Why? You also contradict yourself when you talk about high
mineral levels. NONE of the past studies which found "benefits" from
drinking fluoridated water examined differing mineral levels in water as
a possible confounding factor in tooth decay differences between
communities. By your own definition then, those studies that didn't
control for all background variables, like high mineral levels in water,
should be turfed. Is that correct?

Just in case you want to do some research into fluoridation, I have
provided SOME references. Others can be found in my signature file.

Regards, Elke
ps: your Medline search on one of the hot spots, fluoridation and hip
fracture, covered in another post.
--------
   Colquhoun J. Fluoridation in New Zealand: New evidence. Am
Lab;17:(5)66-72,  (6) 98-102,1985.
   Colquhoun J. Child dental health differences in New Zealand Community
Health Studies; 11:85-90, 1987.
   Colquhoun J. Fluorides and the decline in tooth decay in New Zealand.
Fluoride; 26:125-134, 1993. Decline in tooth decay commenced before and
independently of fluoridation or other uses of fluoride.
  Colquhoun J. Flawed Foundation: A ReExamination Of The Scientific Basis
For a Dental Benefit From Fluoridation, Community Health Studies, XIV(3):
288-296
   DePaola PF et al. Changes in caries prevalence of  Massachusetts
children over thirty years. J Dental Res; 60:360, 1981. Reports a decline
in caries prevalence of 40-50%, both in fluoridated and in unfluoridated
communities.
  Diesendorf M. The mystery of declining tooth decay, Nature, 322:125-9,
1986; "Large temp{*filter*}reductions in tooth decay, which cannot be
attributed to fluoridation, have been observed in both unfluoridated and
fluoridated areas of at least eight developed countries over the past
thirty years."
  Diesendorf M. A Re-examination of Australian fluoridation trials.
Search; 17:256-61,1986.
  Glass. Secular changes in caries prevalence in two Masachusetts towns.
Caries Research; 15:445-50, 1980. Decline in caries prevalence in
nonfluoridated community equals that of fluoridated community ('58-'78).
 Gray AS. Fluoridation: time for a new baseline? J Canadian Dent Assn.,
53:763-5, 1987.
  Hildebolt C.F., et al.,  Caries Prevalences Among Geochemical Regions
of Missouri, American Journal of Physical Anthropology, 78 (1989), 79-92.
  Jones T., Steelink C., and Sierka J.,  An Analysis of the Causes of
Tooth Decay in Children In Tucson, Arizona, Fluoride, 27:4 (October,
1994), p. 238; abstracted from a paper presented at the Annual Meeting of
the American Association for the Advancement of Science, San Franciso
USA, February, 22, 1994.
  Kalsbeek H. and Verrips G.H.W., Dental Caries Prevalence and the Use of
Fluorides in Different European Countries, J. Dental Research, 69
(Special Issue):728-732, February, 1990; "No clear relationship was
discernible between the availability of fluoridated water and toothpaste,
on the one hand, and DMFT on the other."  ***This runs contrary to
dentistry's claim that tooth decay is lower in fluoridated areas. It also
casts a shadow on the abstracts by Renson CE. in your medline search on
fluoride toothpaste.*** See also Ziegelbecker below.
  Scott F. Editorial, Fluoridation: more evidence it is not safe or
effective. Am Lab; June 1986.
  Steelink C.,  Fluoridation controversy,  Letters, Chemical and
Engineering News, (July 27, 1992)
  Teotio S.P.S., and Teotia M.,  Dental Caries: A Disorder of High
Fluoride And Low Dietary Calcium Interactions (30 years of Personal
Research),  Fluoride, 27:2 (April, 1994), 59-66. Study supported by funds
from the Government of India and the International Development Research
Centre, Canada.  The more fluoride, the higher the decay rates!!!!!!
  Tijmstra T et al. Community Dentistry and {*filter*}Epidemiology; 6:227-30,
1978. When children are matched by fathers' occupation, candy consumption
and toothbrushing habits, the supposed reduction in caries among fluoride
users vanishes.
 Yiamouyiannis J. Water fluoridation and tooth decay: results from the
1986-1987 National Survey of U.S. schoolchildren. Fluoride; 23:55-67,
1990. No difference.
  Ziegelbecker R. Fluoridated Water and Teeth. Fluoride; 14:123-8, 1981.
European scientists, in evaluating USPHS claims of fluoride dental
benefits, find these supposed benefits are random, i.e. not dose-related,
and are unconvincing whereas the toxicity (dental fluorosis) is
dose-related.
  Ziegelbecker R., and Ziegelbecker R.C.,  WHO Data on Dental Caries and
Natural Water Fluoride Levels,  Fluoride, 26:4, 263-266, October, 1993
  National Dental Caries Prevalence Survey of 1979-80. NIH Pub. No.
82-2245, March 1982. Fails to demonstrate any advantage of  artificial
fluoridation.
  Robert Wood Johnson Foundation Special Report No. 2, National
Preventive Dentistry Demonstration Program 1983. Found no benefit from
topical treatments tried in a four-year test in
ten differing communities.
 Robert Wood Johnson Foundation (a Rand report), The Costs, Effects, and
Benefits of Preventive Dental Care: A Literature Review, Craig Foch,
N-1732-RWJF, December 1981. "Extrapolation of treatment-effectiveness
results from small-scale clinical or field trials to hypothetical
situations, as widely practiced in the literature, is simply not
warranted by available evidence."
-------------
NOTE: Fluoride is the Journal of the International Society for Fluoride
Research. For more information, contact Dr. John Colquhoun, 81A Landscape
Road, Mt Eden, Auckland 4, NZ

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