Talk:Water fluoridation

This entire article ....

The entire article on water fluoridation is very unbalanced. Criticism of it seems to be limited to negatively calling it 'conspiracy theories'. Funny thing is, in this case, the conspiracy happens to be a true one. Read the book, 'The Fluoride Deception' By Christopher Bryson. No, it's not some quack paranoia book full of sensationalism with no references or research. It's a book by a BBC journalist, and if you want references and proof, there is PAGES of them at the back of the book.

After going through the references, the links to the manhattan project, aluminium manufacture and fluoride as a waste product with no use, dumping it into water supplies to get rid of it, is all proven in the book. This is one of the biggest medical and governmental coverups in 50 odd years.

The whole article needs to be re written, using references and evidence from the book (many from science journals) to show both sides of the story.

50 years from now, we will be shaking our heads at how we were dumb enough to put it in toothpaste and dump it into water, in the same way we laugh at how dumb it was to add radium to skin creams at one time. — Preceding unsigned comment added by 70.75.21.118 (talk) 00:16, 3 November 2012 (UTC)

We need good references in scientific journals. If any of the references you mentioned satisfy that criteria, please let us know. TippyGoomba (talk) 23:53, 4 November 2012 (UTC)

The dentists who support this also suggest the mercury in amalgams is totally safe. How can non-scientists/non-physicians be so incredibly knowledgeable completely outside of their own fields? — Preceding unsigned comment added by 64.134.237.16 (talk) 05:35, 29 January 2013 (UTC)

Absolutely. This article is so one-sided that there's hardly any baby with the bathwater. We should merge it with the well-sourced and neutrally-written article Water fluoridation controversy. Most of the content honestly isn't worth keeping, but I made a new talk section at bottom for discussion.Boleroinferno (talk) 20:17, 18 March 2013 (UTC)

Instead of talking about updating this article with this research, why not just do it? I'm not trolling, I'm being serious. Lets get the ball rolling here. Neillithan (talk) 06:21, 21 March 2013 (UTC)

Disagree, that's not a good idea. The Bryson book is not an acceptable source to support scientific or medical content in this article, see WP:MEDRS for Wikipedia's sourcing guidelines for biomedical information. The Bryson book is appropriate for use in the article Water fluoridation controversy, and I see it is already used there. Zad68 12:16, 21 March 2013 (UTC)

section on studies and reviews

hatter per WP:NOTFORUM

I think it would be great to start a section on the general quality of the research, the different types of research, studies and reviews in the article. Tilapidated (talk) 19:23, 20 February 2013 (UTC) I took the liberty of beginning this - I am a little troubled at the overall poor quality of the data - I hope someone will be able to add more impressive reviews and meta-studies. Tilapidated (talk) 21:10, 20 February 2013 (UTC) It appears that many papers/studies on PubMed are leaning away from water fluoridation. See "Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland." "In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined." "Caries prevalence after cessation of water fluoridation in La Salud, Cuba" "In the past, caries has usually increased after cessation of water fluoridation. More recently an opposite trend could be observed: following the cessation of drinking water fluoridation, in contrast to an expected rise in caries prevalence, DMFT and DMFS values remained at a low level for 6-9-year-olds and to decrease for 10/11-year-olds. In the 12/13-year-olds, there was a significant decrease." "Decline of caries prevalence after the cessation of water fluoridation in the former East Germany" "In contrast to the anticipated increase in dental caries following the cessation of water fluoridation in the cities Chemnitz and Plauen, a significant fall in caries prevalence was observed. This corresponded to the national caries decline and appears to be a new population-wide phenomenon. There is still no explanation for the pattern." "Prevalence and severity of dental caries in adolescents aged 12 and 15 living in communities with various fluoride concentrations" "In an analysis of caries severity (DMFT > or = 4), both adolescents with very mild/mild and moderate/severe dental fluorosis have higher caries severity. Fluoride exposure (measured through fluorosis presence) does not appear to be reducing the caries prevalence (DMFT > 0) or caries severity (DMFT > or = 4) in these high-altitude communities." "An epidemiological profile of dental caries in 12-year-old children residing in cities with and without fluoridated water supply in the central western area of the State of São Paulo, Brazil" "There was no statistically significant difference between DMFT in municipalities of the same size, regardless of the presence or absence of fluoride in the water supply... Prevalence of caries in the region was 'high', with a DMFT of 4.82, thus failing to reach the goals set for the year 2000." "Patterns of dental caries following the cessation of water fluoridation" Canada "The prevalence of caries (assessed in 5,927 children, grades 2, 3, 8, 9) decreased over time in the fluoridation-ended community while remaining unchanged in the fluoridated community." "The fluoride content of drinking water and caries experience in 15-19 year old school children in Ibadan, Nigeria" "Nine hundred and fifty five students aged 15-19 years randomly selected from eleven secondary schools in Ibadan metropolis were examined for dental caries over a period of 4-5 months. Only teeth with obvious cavitations were recorded as being carious using the WHO standard method. The fluoride level of the different water sources was between 0.02 and 0.03 ppm. [only] Forty-four (4.6%) of the children had dental caries. In conclusion, both the fluoride level and caries prevalence were low." "The effects of a break in water fluoridation on the development of dental caries and fluorosis" North Carolina "It was concluded that while the break had little effect on caries, dental fluorosis is sensitive to even small changes in fluoride exposure from drinking water, and this sensitivity is greater at 1 to 3 years of age than at 4 or 5 years." "New evidence on fluoridation" "A review of recent scientific literature reveals a consistent pattern of evidence--hip fractures, skeletal fluorosis, the effect of fluoride on bone structure, fluoride levels in bones and osteosarcomas--pointing to the existence of causal mechanisms by which fluoride damages bones. In addition, there is evidence, accepted by some eminent dental researchers and at least one leading United States proponent of fluoridation, that there is negligible benefit from ingesting fluoride, and that any (small) benefit from fluoridation comes from the action of fluoride at the surface of the teeth before fluoridated water is swallowed." "Is there a need of extra fluoride in children?" "The issues related to fluoridation of water or fortification of tooth paste with compounds of fluorides are controversial. Fluoride is stored mainly in the bones, where it increases the density and changes the internal architecture, makes it osteoporotic and more prone to fractures. Fluoride consumption by human beings increases the general cancer death rate, disrupts the synthesis of collagen and leads to the breakdown of collagen in bone, tendon, muscle, skin, cartilage, lungs, kidney and trachea, causing disruptive effect on various tissues in the body. It inhibits antibody formation, disturbs immune system and makes the child prone to malignancy. Fluoride has been categorized as a protoplasmic poison and any additional ingestion of fluoride by children is undesirable." "Developmental fluoride neurotoxicity: a systematic review and meta-analysis" "The results support the possibility of an adverse effect of high fluoride exposure on children's neurodevelopment." "Impact of fluoride on Neurological Development in Children" "Some studies suggested that even slightly increased fluoride exposure could be toxic to the brain."... "Fluoride seems to fit in with LEAD, MERCURY, and other poisons that cause chemical brain drain," Grandjean says. "The effect of each toxicant may seem small, but the combined damage on a population scale can be serious, especially because the brain power of the next generation is crucial to all of us." "Effects of the fluoride on the central nervous system" "The prolonged ingestion of F may cause significant damage to health and particularly to the nervous system. Therefore, it is important to be aware of this serious problem and avoid the use of toothpaste and items that contain F, particularly in children as they are more susceptible to the toxic effects of F." "Fluorine as a factor in premature aging" "In conclusions, the use of fluoride, particularly by dentists and pediatricians, must be controlled and adapted to individual needs." "Oral manifestations of thyroid disorders and its management" "Fluoride was used as a drug to treat hyperthyroidism because it reduces thyroid activity quite effectively. This is due to the ability of fluoride to mimic the action of thyrotropin (TSH). Excess fluoride correlates with the other thyroid-related issues such as iodine deficiency. Fluorine and iodine, both being members of the halogen group of atoms, have an antagonistic relationship. When there is excess of fluoride in the body it can interfere with the function of the thyroid gland. Thus, fluoride has been linked to thyroid problems." The prior therapeutic use of F to reduce thyroid hormone levels in cases of thyrotoxicosis is well documented (Goldemberg, (1926, 1930, 1932); May (1935, 1937); Orlowski (1932) and Galletti and G. Joyet, (1958)). "Fluoridation: a fifty-year-old accepted but unconfirmed hypothesis" "The fifty-year-old fluoridation hypothesis has not been confirmed. Despite this, millions of people are still medicated with fluoride by government decree, on the assumption that this process has been proved to be entirely safe, and very efficacious in reducing dental caries. In fact, the scientific basis of fluoridation is very unsatisfactory. It is promoted, in the main, by emotion-based 'endorsements' rather than by scientifically-acceptable evidence." "Fluoridation: a violation of medical ethics and human rights" "Silicofluorides, widely used in water fluoridation, are unlicensed medicinal substances, administered to large populations without informed consent or supervision by a qualified medical practitioner. Fluoridation fails the test of reliability and specificity, and, lacking toxicity testing of silicofluorides, constitutes unlawful medical research. It is banned in most of Europe; European Union human rights legislation makes it illegal. Silicofluorides have never been submitted to the U.S. FDA for approval as medicines. The ethical validity of fluoridation policy does not stand up to scrutiny relative to the Nuremberg Code and other codes of medical ethics, including the Council of Europe's Biomedical Convention of 1999. The police power of the State has been used in the United States to override health concerns, with the support of the courts, which have given deference to health authorities." — Preceding unsigned comment added by 99.61.178.14 (talk) 19:44, 6 April 2013 (UTC) I reviewed the sources provided: PMID 9758426 is a primary study from 1998 PMID 10601780 is a primary study from 2000 PMID 11014515 is a primary study from 2000 PMID 17436973 is a primary study from 2007 PMID 12244360 is a primary study from 2002 PMID 11153562 is a primary study from 2001 PMID 18756850 is a primary study from 2008 PMID 10728978 is a primary study from 2000 PMID 9161076 is a review from 1997 PMID 19812419 is an editorial from 2009 PMID 22820538 is a 2012 review article but with extremely qualified findings ("The results suggest that fluoride may be a developmental neurotoxicant...", "The results support the possibility...") with no conclusion of a cause-and-effect relationship. The HSPH article is a commentary on PMID 22820538 PMID 21255877 focuses on "populations exposed to the intake of this mineral at concentrations outside official guidelines", and so outside the scope of this article PMID 16892576 is a review from 2004, also doesn't appear to be talking about flouride levels like those discussed in this article PMID 21966646 talks about treatment of patients with thyroid disfuction, does not appear to discuss flouride levels like those discussed in this article PMID 3059145 is a Medical Hypotheses article from 1988 PMID 12749628 is an editorial from 2003 In short, not a single one of these articles looks appropriate for use here. Please refer to WP:MEDRS for Wikipedia's standards for sourcing biomedical information, and please take care not to misrepresent the applicability of sources. Zad68 03:31, 7 April 2013 (UTC) WP:MEDRS states that PubMed is an excellent source of information. Are you stating that it is not? — Preceding unsigned comment added by 99.61.178.14 (talk) 04:48, 7 April 2013 (UTC) See WP:MEDDATE. TippyGoomba (talk) 04:58, 7 April 2013 (UTC) @TippyGoomba - WP:MEDDATE is a rule of thumb but isn't mandatory. "Here are some rules of thumb for keeping an article up-to-date, while maintaining the more-important goal of reliability. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published." I am still searching for safety studies done on consuming & bathing in water with added hexafluorosilicic acid instead of calcium fluoride. There is quite a difference in the LD50 toxicity levels. The LD50 for calcium fluoride is 4250 mg/kg. The LD50 for hexafluorosilicic acid is 70 mg/kg. Hexfluorosilicic acid (also known as hydrofluorosilicic acid) was banned by the EU in 2006 due to lack of toxicological data to show it was safe for humans and the environment yet this banned biocide/pesticide is used to fluoridate the water. Confounding many of these epidemiological studies is the fact that artificially added inorganic fluoride is much more damaging to living tissue (not to mention corrosive to pipes) than organic, naturally occurring calcium fluoride. And when measuring only the absolute levels of the fluoride anion, studies end up comparing apples to oranges. — Preceding unsigned comment added by 99.61.178.14 (talk) 05:52, 7 April 2013 (UTC) Are you trying to be funny, or just bog-ignorant? CaF2 is organic??? If you don't know anything about chemistry, much less organic chemistry, not even to mention metabolic or biochemistry, and too dumb or bone-idle to do some homework, then stop wasting the time of people who have something more useful to do. JonRichfield (talk) 06:41, 7 April 2013 (UTC) @JonRichfield - When I used the word "organic", I was using it in an "informal way". See Wikipedia, "Organic Matter". "Organic matter is present throughout the ecosystem. After degrading and reacting, it can then move into soil and mainstream water via waterflow. A majority of organic matter not already in the soil comes from groundwater." Didn't mean to enrage anyone. I stand corrected. — Preceding unsigned comment added by 99.61.178.14 (talk) 08:13, 7 April 2013 (UTC) An informal way? You mean total, radical incomprehension of highschool basics? You want organic flourine? Try a few ppm of fluocitrate or the like; that is organic. You didn't enrage me, you horrified me, much as if I found a fellow-passenger wrestling with the pilot of the plane I was a passenger in, because he thought the pilot didn't understand about placating the gremlins holding up the wings. Am I making it a bit clearer now? JonRichfield (talk) 20:09, 10 April 2013 (UTC) You appear to be confused. WP:MEDDATE is the same essay as WP:MEDRS, the one you quoted as saying "PubMed is an excellent source of information" in order to dispute Zad's observation that your citations are out of date. TippyGoomba (talk) 06:03, 7 April 2013 (UTC) @TippyGoomba - What date should it be? Can you find something more recent? It doesn't appear that there are any peer-reviewed safety studies done on consuming hexafluorosilicic acid, aka hydrofluorosilicic acid, in tap water. Odd when you consider the difference in their LD50 toxicity levels to naturally occurring "calcium fluoride". Here's some information on hexafluorosilicic acid used for water fluoridation. See "Sodium Hexafluorosilicate and Fluorosilicic Acid, Review of Toxicological Literature". Its just a pesticide and rodenticide. Lets add it to tap water and feed it to American infants and children. — Preceding unsigned comment added by 99.61.178.14 (talk) 19:50, 7 April 2013 (UTC) And with this last response you reveal that your intention is not article development in line with Wikipedia policy and guideline but rather an intention to use Wikipedia articles to advance a position. See WP:NOTADVOCACY. As this discussion was proposed in bad faith, it is now closed. Zad68 22:32, 7 April 2013 (UTC)

When reporting the results a scientific review, is it appropriate to substitute other researcher's interpretations, or should we report on the original author's conclusions?

Currently the article section in question reads: "A 2000 systematic review found that water fluoridation was statistically associated with a decreased proportion of children with cavities (the median of mean decreases was 14.6%, the range −5 to 64%), and with a decrease in decayed, missing, and filled primary teeth (the median of mean decreases was 2.25 teeth, the range 0.5–4.4 teeth), which is roughly equivalent to preventing 40% of cavities."

The authors of the review cited state "The best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence, both as measured by the proportion of children who are caries free and by the mean change in dmft/DMFT score. The studies were of moderate quality (level B), but of limited quantity. The degree to which caries is reduced, however, is not clear from the data available. The range of the mean difference in the proportion (%) of caries-free children is -5.0 to 64%, with a median of 14.6% (interquartile range 5.05, 22.1%). " and that "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." http://www.york.ac.uk/inst/crd/fluoridnew.htm , http://www.york.ac.uk/inst/crd/fluorid.htm

The York authors' conclusion is that, while the evidence suggests that fluoridation reduces caries, it is not possible to make definitive statements about levels of reduction of caries based on their data. This has been replaced with the interpretation of Worthington H, Clarkson J. (The Evidence Base for Topical Fluorides. Community Dental Health, 2003, 20: 74-76.) cited in a pamphlet by the British Fluoridation society offering the interpretation their interpretation of the York data as "roughly equivalent to preventing 40% of cavities."

Tilapidated (talk) 18:39, 22 February 2013 (UTC)

I propose presenting the views of both the authors and commentators (from quality peer reviewed sources) and clearly attributing them, but the current phrasing (omitting the original conclusion and inserting another) suggests that the 40% figure comes from the review, and obscures the different conclusions of the original study authors. Tilapidated (talk) 18:39, 22 February 2013 (UTC)

I propose the following wording for the paragraph (citations are not shown in this version): "A 2000 systematic review of 214 studies (The York Review) stated that 'the best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence', but 'that the degree to which caries is reduced, however, was not clear from the data available', and that 'the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth'. Commentators (including Worthington et al) propose that the York data may be interpreted as "roughly equivalent to preventing 40% of cavities."

The review found that the evidence was of moderate quality: many studies did not attempt to reduce observer bias, control for confounding factors, report variance measures, or use appropriate analysis. Although no major differences between natural and artificial fluoridation were apparent, the evidence was inadequate to reach a conclusion about any differences."

The conclusions quoted are from the study or the subsequent author's statement. Tilapidated (talk) 18:59, 22 February 2013 (UTC)

• Comment This RFC seems to be comparing apples and oranges, the two items mentioned aren't dependent on each other. Worthington and Clarkson's analysis is from PMID 12914024, it may have been cited in a pamphlet but it's also cited by, for example, Ireland's comprehensive Oral Health Services Research Centre report, and was made in direct comment and review of the York report. Worthington and Clarkson are the editors for the Cochrane Oral Health Group, which makes them as prestigious and reliable a source as needed for the kind of basic math analysis they're making. If that's the apple, the orange is whether the York study's findings are accurately represented in the article. As has been mentioned elsewhere on this Talk page, the view is that the specific ranges provided in the York report are represented in the article. Expanding the citing of this 13-year-old report (especially as we have newer sources reviewing the same data) to essentially repeat the fact that the range of the specific values provided was broad seems unnecessary. Zad68 18:55, 22 February 2013 (UTC)

I'm not suggesting that Worthington et al are not suitable commentary, simply that we should not substitute their conclusions for those of the original authors. I propose mentioning Worthington's comment, but clearly attributing it. Unfortunately the math is far from basic. Simply taking the median of the means of the studies, and then attempting to figure out from that the reduction in caries is something the York team declines to do on the basis of their understanding of the quality of the data. There are all kinds of methodological reasons why this is not a simple or appropriate thing to do, as they point out in several different places (another example "The best available evidence on stopping water fluoridation indicates that when fluoridation is discontinued caries prevalence appears to increase in the area that had been fluoridated compared with the control area. Interpreting from this data the degree to which water fluoridation works to reduce caries is more difficult" page 67 of the report). I'm not opposed to showing that others do it, but I think it's important to point out that the authors specifically claim that the data doesn't support it.

Since we do mention the 13 year old article, we should represent what it says accurately. Tilapidated (talk) 19:03, 22 February 2013 (UTC)

The statement above "cited in a pamphlet by the British Fluoridation society" isn't a helpful characterisation of the source. Where it ends up getting cited is of little matter. More important to consider whether the authors and journal form a reliable source. They do. I now have access to the editorial and is indeed those esteemed authors' interpretation of the York figures. Since as Wikipedian's we are unable to perform such interpretations, we rely on the best authors in the best publications to do that for us. The article text currently makes it quite clear, both in that paragraph and surrounding text, that studies vary hugely in their numbers and that the York findings were of a wide range so I don't think we are misguiding the readers at all. In fact, wrt the 14.6% figure, Worthington and Clarkson state "It is important to emphasise that a change of 15% in caries free is a huge reduction in caries". Colin°^Talk 20:07, 22 February 2013 (UTC)

I agree - I was simply citing where I was shown it (by you). It's standard practice to report where you saw citations if you have not seen the original. I also agree that Worthington is an appropriate source to cite.

Where I disagree is that we should, in describing the York Review's findings, replace their conclusions with those of Worthington. We should represent Worthington, but separate from our reporting of the York review's findings. The two sources disagree on the meaning of the data - we should reflect that. The 15% figure is the median of the means of the studies reviewed, and the York authors assert that in their opinion it is not possible given the quality of the data to draw conclusions about the degree of reduction from it. That Worthington disagrees is fine, but it's not our role to replace one set of findings with another. Tilapidated (talk) 20:20, 22 February 2013 (UTC)

We have policies for this. The York Review looked at primary sources and is so better that the original sources and is a reliable source. It also looks to be unbiased when compared to the cheery-picking of many of the tertiary sources that comment on the York Review to support their own field or specialty. However see Wikipedia:PSTS#Primary.2C_secondary_and_tertiary_sources and make your own mind up.--Aspro (talk) 20:37, 22 February 2013 (UTC)

There is nothing in PSTS to say that tertiary sources are more biased or likely to cherry-pick. Indeed the whole ethos of Wikipedia is that editors must not themselves cherry pick. Therefore, I'm far more comfortable with Worthington and Clarkson of the Cochrane Oral Health Group interpreting the York review than User:Tilapidated, User:Colin, User:Aspro or User:AnyoneElse. Because experience is that Wikipedian's are awful cherry pickers. It is easy to assume "X says something I disagree with => X must be biased". Far harder to accept that X may have a point even if I disagree with them. But ultimately I'm puzzled by the fuss created because the section on efficacy is quite clear about the range of study results and the lack of truly high-quality research in this area. The worry over who's wording this is isn't really that important to the reader: like worrying which of the York study's authors wrote that bit or who of Worthington or Clarkson came up with the 40% figure. We cite where it came from, and the reader can follow the links if they care to. Colin°^Talk 22:24, 22 February 2013 (UTC)

That's a bizarre characterization Colin - it is not me interpreting the York Review. My view on this is that we should present the conclusions of the York Review, and the conclusions of relevant commentators, not remove the conclusions of the review authors and replace them with the commentators, especially where there is a direct conflict between them. The issue is not simply the range, but the fact that the York authors specifically state that the data does not support conclusions in the size of the effect. Tilapidated (talk) 23:21, 22 February 2013 (UTC)

WP also expects editors to use their common sense. Say a tire/tyre manufacture reviews a review, on general aircraft safety. Would you expect it to only comment on those aspects that affects it position... Yes. Would it included self criticism on over-speed-tire busts (pilot error) etc.? Or included its on analysis of air craft safety that concerns flight engineering and systems that is out of its field of expertise? No. So it would cheery pick from the whole mass of data. Therefore, they would not give balanced view of the whole original study. Thus, is the problem with many and most tertiary reviews and why we should not use them as summary’s. I would have been shot if I included such a reference in a technical report.--Aspro (talk) 23:07, 22 February 2013 (UTC)

Wikipedia is quite different source-wise and editing-wise from any other publication on the planet. Academic writing would cite primary sources and landmark reviews only -- citing a plain old literature review would be very bad form. As for common-sense, I have no reason to think that Worthington and Clarkson's comments on the York data are faulty and every reason to think they know an awful lot more about the subject than any of us. Colin°^Talk 23:20, 22 February 2013 (UTC)

Colin - I'm not sure you understand what is being proposed - you seem to be arguing a point that no one is making. Worthington disagrees with the conclusions of the York review. Replacing the York review's conclusions with those of Worthington is confusing and does not make plain the range of opinions. The proposal is to state the conclusions of both, but state and attribute them clearly. I'm baffled as to why you would want to oppose that. Tilapidated (talk) 23:24, 22 February 2013 (UTC)

"Worthington disagrees with the conclusions of the York review" Really? You know them personally? You've read the paper and they say this? -- Colin°^Talk 23:28, 22 February 2013 (UTC)

Actually Colin. The WP article say: “A 2000 systematic review found that water fluoridation was statistically associated with a decreased proportion of children with cavities (the median of mean decreases was 14.6%, the range −5 to 64%), and with a decrease in decayed, missing, and filled primary teeth (the median of mean decreases was 2.25 teeth, the range 0.5–4.4 teeth),[11] which is roughly equivalent to preventing 40% of cavities.[52]” (emphases mine). Yet, Worthington is accentual talking about 'topical' fluorides -which the York Review does give some credence to . So this sentence in the article is misleading to link it to water fluoridation. This goes back to my comment above, that I would have been shot for mixing things up like this.--Aspro (talk) 00:10, 23 February 2013 (UTC)

I'm aware of what the article is about and fully aware of what Worthington and Clarkson wrote because I've read it. If you had, you wouldn't make this remark. Colin°^Talk 16:01, 23 February 2013 (UTC)

Honestly, Colin, I have a hard time following you. I think you are misunderstanding me for comic effect? Worthington, in his paper (the one we're talking about above) offers an estimate of the percentage reduction in caries based on the median of the means of the 214 studies in the York Report. In the York report (and in subsequent writing) the York authors explicitly state that this is not possible based on the data quality. They come to different and incompatible conclusions about the ability to make a determination about the size of the effect. I hope that is clear? It is these different conclusions that make it inappropriate to remove York's conclusions and substitute Worthington. We should cite both, but be clear which is the original author and which is commentary. Tilapidated (talk) 23:42, 22 February 2013 (UTC)

On Wikipedia, we are writing an encyclopaedia, not an academic journal. For that to work, and be accessible to a wide range of readers, some interpretation of complex statistics and figures is helpful. But we cannot do such interpretations ourselves beyond the most basic maths per WP:OR. The Worthington and Clarkson figure is an interpretation of the York results. Several times in the section we talk of "reduction in cavities" but the York figures are a "reduction in children with any cavities" or a "decrease in decayed teeth". For the reader to compare the various reviews, it is helpful to not be comparing apples with oranges. The Worthington and Clarkson figure lets the reader see that the median result in the York review roughly corresponds to a 40% reduction in cavities. But we make quite clear that the York results cover a wide spread. Indeed reading the whole section, the reader is left in no doubt that reviews vary widely in their results and there is no one true figure.

Pulling out Worthington and Clarkson's 40% figure into its own paragraph ("Other researchers claim that fluoridation results in a reduction of 40% in cavities.") made it appear this value was the result of different review or even a different study performed by those authors. It isn't and so doing that is misleading.

I think the statement "range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth" is a quite misleading summary of their figures. Although factually correct, it gives equal emphasis to the "slight disbenefit" side which is clearly an outlier in their data (it comes from one study out of 30, whereas 20 showed a significant benefit). It should be noted that this text is from a press-release on their website and not from the report itself or from a peer-reviewed journal. It is the sort of phrasing someone might make in a heated argument to make a point but hardly a balanced summary of the data.

On an encyclopaedia, the facts are more important than academic trivia like "The York Review" or "Worthington and Clarkson say..." This is just noise. The reader says "Why am I being told these names?" I do see some of Tilapidated's points though I feel the reader is not being nearly as misled as he thinks. How about

A 2000 systematic review of 30 studies found that water fluoridation was statistically associated with a decreased proportion of children with cavities (the median of mean decreases was 14.6%, the range −5 to 64%), and with a decrease in decayed, missing, and filled primary teeth (the median of mean decreases was 2.25 teeth, the range 0.5–4.4 teeth),[York] The range of study results varied considerably but for comparison with other reviews, the median figures have been interpreted as roughly equivalent to preventing 40% of cavities.[Worthington]

Colin°^Talk 16:01, 23 February 2013 (UTC)

Colin - there's plenty of interpretation in the article - this section is specifically on the scientific basis, and calls out several key literature reviews (I think there should be more, and more recent, but that's another issue). This isn't an introductory paragraph, it's a section devoted to the key science. I realize that what the York Review concluded isn't what you would have liked, but we need to stick to the science. It's fine to note that commentators have interpreted their figures differently, but the York authors are specific in pointing out that the quality of the data does not, in their view, allow conclusions about the size of the effect.

You say you are worried that "Pulling out Worthington and Clarkson's 40% figure into its own paragraph ... made it appear this value was the result of different review" - that's the point - Worthington is not an author of this review - his conclusions are a different piece of work, commenting on the York Review. They're not the same review.

Perhaps if you don't have a background in statistics this could seem obtuse, and it definitely sounds as if you feel that this is minor. Your statement that the -5% study is 'clearly an outlier' makes me think that you might not understand what the review is doing. This isn't a normal distribution that they are dealing with - it's the median of the means of all the 26 studies. Without knowing the population sizes, and the ranges and distribution characteristics of those studies, drawing conclusions about the size of the effect is impossible, and whether or not any particular study is an outlier is impossible (that data is not available for all the studies). When they say it's impossible to know the size of the effect from their data, they are making a statement about the quality of the data, not about fluoridation.

I'm not sure if I'm more amused or horrified that you characterize this as 'academic trivia'. To go ahead and do the calculation for them is to misrepresent their findings. Now, I'm happy to note that some commentators have gone ahead and done this, presumably they have their reasons, and that's fine, but to not represent the findings of the study is not a commitment to the facts, its a misrepresentation of the facts. Again, you may think it is misleading, but "range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth" is THEIR summary of their study. For the purposes of this article, whether you agree with them or not isn't the point. Tilapidated (talk) 17:36, 23 February 2013 (UTC)

As long as you keep saying things like "I realize that what the York Review concluded isn't what you would have liked, but we need to stick to the science" there really is no point in you or I conversing. I've made my position clear: I have none. Worthington is a not separate review but is a separate "commentator" as you put it earlier. And Worthington is a she. Again, I see little point in arguing over what that Worthington states with someone who misinterprets from a position of ignorance. I'm aware the studies don't form a normal distribution. But neither are they utterly random. Otherwise the author's wouldn't have stated their median or interquartile range but merely held up their hands in despair. But they did give the median figures and the 40% is an interpretation of that median so no more incorrect to give than the 14.6% decrease or the 2.25 teeth. Just another way of looking at those figures. I appreciate the nature of the studies and their analysis means this median is less useful a figure and that perhaps some authors are over-emphasising it.

The single negative result is unique, unrepresentative of the 30 studies and drowned out by the 20 studies that show a significant positive result. To give it equal weight when characterising the range is simply misleading. But this is beside the point -- we don't source an FA from a press-release on a website. Let's stick to what the serious academic literature says.

Re-read what I said was "academic trivia". Again, it is quite tiresome to argue with someone who misinterprets what the other person said. Must I spend most of my response correcting your mistakes while ignoring your insults?

Well I've offered a suggested change. It increases the emphasis on the wide range of results and makes it clear what the 40% figure is an interpretation of. Let's see what other people think, and I suggest you wait a few days till folk get back from the weekend. Colin°^Talk 20:23, 23 February 2013 (UTC)

Colin, let's get a few of the facts straight - the York authors don't throw up their hands in despair, no one is claiming they do. They quote the median and the ranges, and conclude that the evidence shows a benefit to fluoridation. They then explicitly go on (in the paper - you can ignore the press release, it's simply a re-stating of the paper, and I thought it might help you to understand the issues in the paper) to state that their data does not allow conclusions as to the magnitude of the benefit.

You may think that the York review is misleading, but frankly that's not relevant. Your or my opinion of the scientists' interpretation is not important - stating what their interpretation was is what is important. You statement that the 40% interpretation is no more incorrect than the other is fascinating, but not grounds for inclusion in an encyclopedia article. Your position disagrees with the author's of the studies. You have someone who commented on the study who agrees with you, that's fine, but it is important to include the conclusions of the original authors, even when they don't agree with our own positions.

Worthington's 40% is an interpretation, but it's an interpretation that is incompatible with the author of the study's interpretation, which is that you cannot conclude the degree of effect on the basis of their data. Worthington is not part of the review - she is writing a separate commentary on it.

You seem to be misunderstanding the claim that is being made still. The authors do claim a beneficial result, and don't give equal weight to the negative result, but the essential problem with the data quality (according to the authors) is that there is no way to tell reliably how much of a beneficial effect there is or how much weight to give to each study. That is why they conclude that there is an effect, but that it's impossible to know how big it is.

As I've said time and again, commentary of the study by third parties has a place, but it's not in the sentence where we report what the study found, especially where it conflicts with the study.

I have not insulted you. Tilapidated (talk) 22:09, 23 February 2013 (UTC)

Since nearly every statement above is a misinterpretation of what I said, I see no further benefit in continuing the conversation between us two. If someone else joins the conversation (be patient) then perhaps they can help or mediate. Colin°^Talk 22:39, 23 February 2013 (UTC)

From the above:Since nearly every statement above is a misinterpretation of what I said, I see no further benefit in continuing the conversation between us two. If someone else joins the conversation (be patient) then perhaps they can help or mediate.... It boils down to your view Colin, It doesn't it make sense on the basis of the evidence of resent scientific reviews of the literature. Water fluoridation has moved from a scientific hypothesis to a religious cult. Today, we need good evidence. What goes on WP should have some basis on scientific fact. Not, Oh well. we believed this for the last forty years so it must be true. Colin, Stop bashing your head against the brick wall of blind believe. To day we have Google and Google Scholar and medical practitioners (in Europe) have free access to data bases such as Ovid. Most of Europe ( and China et.al.) has now abandoned water fluoridation as a waste of money and scientific gobble gook. The English version of WP covers the English speaking world – please stop trying to impose you unscientific beliefs upon us for the reason it gives you a nice warm feeling inside. It is dental heath which matter -and don't forget you that!--Aspro (talk) 01:12, 24 February 2013 (UTC)

Aspro, per WP:NOTAFORUM any further posts like that will just be deleted. Per WP:NPA further posts like that will get you blocked. I will not warn you again. Stick to discussing the article text wrt the highest quality sources. If you can't do that, don't comment. Colin°^Talk 09:44, 24 February 2013 (UTC)

I'm sorry Colin - I am having a hard time understanding what it is you're trying to communicate. I do hope you try again, Tilapidated (talk) 23:20, 23 February 2013 (UTC)

I am not a big fan of the proposed new wording for a number of reasons "A 2000 systematic review of 214 studies (The York Review) stated that 'the best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence', but 'that the degree to which caries is reduced, however, was not clear from the data available', and that 'the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth'. Commentators (including Worthington et al) propose that the York data may be interpreted as "roughly equivalent to preventing 40% of cavities.""

• 1) If people which to know how many studies it is based on they can look at it.

• 2) We do not name any of the other reviews in the article so why this one?

• 3) It is IMO preferable to paraphrase as is done than to quote the exact wording. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:16, 24 February 2013 (UTC)

Plus the evidence for "does reduce caries" was drawn from far fewer than 214 studies. It is the paucity of even moderate-quality studies that is part of the issue, so claiming that 214 studies produce this result is widely over-stating the evidence-base. Colin°^Talk 09:44, 24 February 2013 (UTC)

Colin - you're quite right on the 214 - it should read 26 - 214 is the total number of studies considered, 26 is the number relevant to this issue.

Jmh - thanks for commenting - there are several studies called out in the science paragraph - I was proposing to name them for clarity, rather than referring to each as 'a study in 2000', or a study in 2007'. It's not important to me to name them, it just seems clearer. Stating the number of studies gives an indication of the scale of the review - several large scale reviews are cited, and there are others that have been proposed as relevant. These large scale literature reviews are one of the best ways of understanding the state of the science. Paraphrasing is fine, the issue is that the original conclusion has been removed and replaced with a conflicting one from another author entirely. Tilapidated (talk) 16:13, 24 February 2013 (UTC)

Support Colin's proposal above as it's a perfectly reasonable and accurate representation of both the York study findings, including a plain-language interpretation of the authors' observation of the wide result ranges, but also cites Worthington appropriately as an expert for a plain-language interpretation of the primary finding of a median 15% (rounded up from York's 14.6%) decrease in caries-free children which is exactly the thing Worthington comments on. The York study cannot at all be used in support of article content suggesting that no benefit was found, or that the benefit suggested by the data was statistically insignificant. York states very clearly and plainly at the introduction of the paragraph discussing the findings, "The best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence, both as measured by the proportion of children who are caries free and by the mean change in dmft/DMFT score." Zad68 21:33, 25 February 2013 (UTC)

Holy-molly Zad. The York review doesn’t suggest that. Have any of you, done any more than skim though and cherry pick? They went on to say What the 'York Review' on the fluoridation of drinking water really found. “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.” From an encyclopedic point of view this analysis should be accurately reflected in its 'proper' context. The word 'suggests ' is as they say based on poor studies. Thus, it is not WP's job to pass judgement on this evidence and unilaterally suggest “that fluoridation of drinking water supplies does reduce caries prevalence.” Surly you see this. We have to report the evidence as accurately as possible. I may have the advantage that havimg working in an R&D environment I am more use to annualising this type of literature but whilst Colin may accuse me of an ad hominem attack, when all I am attempting, is to get him to read the ruddy report as it is written. Why does subject of fluoridation warrant such convoluted debates. Just look at the length of this talk page. The Circular arguments just go round and round – lets just stop it... and just accurately report the unadulterated knowledge of what is and isn't known.--Aspro (talk) 19:06, 26 February 2013 (UTC)

It'd be very nice if you'd assume good faith, stop making snarky comments about your fellow editors at this article, and comment only on the content.

What exactly are you saying is the thing the York review authors do not suggest? The review itself, and the 2003 clarifying comment, state two important things regarding fluoridation and dental health: 1) there is moderate but not good quality evidence that fluoridated water is likely to reduce caries, and 2) the range of benefit of the evidence reviewed was wide. Now, please take a close look at Colin's suggestion above, both items are represented. Perhaps we can change "found" to "suggested". Also note that in the article right now, the very next sentence after this starts "The review found that the evidence was of moderate quality".

You state The word 'suggests ' is as they say based on poor studies - be careful here, the quality of evidence for a consequent increase in fluorosis was described as "poor". The quality of evidence for the reduction in caries was "moderate".

I'm still not seeing a significant problem with how Colin's suggestion, or the existing article content for that matter, seriously misrepresents the sources. Zad68 19:50, 26 February 2013 (UTC)

Request to Aspro - I haven't seen your suggestion for article content. Maybe you could clarify your position on how the sources can best be represented if you'd suggest a specific article content change? Thanks... Zad68 19:53, 26 February 2013 (UTC)

Hey, step back fellas and look at this unemotionally. I'd be happy to clarify my position (and I was trying to do before but obviously not well enough). Remove the opportunity of pro/anti fluoridation faux arguments and rename the article water fluoridates (there are two main common chemical compounds). Then have artifactual water fluoridation as a sub heading. Not a panacea but better than the situation we have at present. Why? The lead in the article: Water fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water has fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride.[2] is misleading. The York Review found that the much quoted studies did not control for any confounding factors. So, to a scientist they are not of a good quality. Argue that as you will but but it doesn’t change anything. So the phrase “ that is effective” needs qualifying with the word 'thought'. Water that contains certain levels of fluoride is 'thought' by some studies to prevent dental caries. Also if drinking water has high 'natural' or 'artificial' fluoridates which go onto cause server dental fluorosis, that make the teeth more susceptible to decay (there is no argument about this, last figures is saw suggested that over the life of a dental patient with server fluorisosis, costs for veneers etc., are currently somewhere in excess of US$10,000). It may be easy to concatenate 'artificial' and 'natural' into the same paragraph... that just-anybody-can-edit but it reads very amateurish. A 'Total dietary fluoride load' sub section can then be added in the appropriate place to give proper context to artificial water fluoridation’s Raison d'être (i.e., too little dietary fluoride) . Thus giving the WP reader (which is why we contribute is it not) a broad NPOV of the subject and the current state of knowledge.--Aspro (talk) 18:29, 27 February 2013 (UTC)

Quit with the "look at this unemotionally" crap please. The only thing I care about here is a high quality article on WP and have zero zip nada emotions wrt fluoridation. The article topic is artificial fluoridation. Deal with it. You are wrong about confounding factors. Read pages 5 and 6 of the report and note the studies were classed "B". That doesn't demote them to junk science as you are trying to make out. They have value but clearly everyone would want better designed studies. Very little in health and medicine is based on A-class research and indeed most government-led initiatives are based on no research whatsoever. Artificial fluoridation does not produce "high" levels of fluoride and does not cause "severe dental fluorosis". Concatenating natural and artificial text, when the sources don't (and they do so rarely) is called synthesis and not allowed per policy. We know why folk want to mix natural and artificial fluoride -- because then the lead image can be horrible brown stained teeth and the lead paragraph can mention brain-damaged children living in some toxic Chinese valley. But our best reliable sources do nothing of the sort, and neither should we. -- Colin°^Talk 19:14, 27 February 2013 (UTC)

Aspro, let me try to summarize your suggestions, and provide my responses:

• You are suggesting that this article should be renamed from "Water fluoridation" to "Water fluoridates" - this would have the effect of expanding the scope of this article from covering the artificial control of the F- level in water for the intended purpose of improving dental health, to the more general topic of the existence of F- in water, no matter how it got there, and not limited to a discussion of considering it for the purposes of dental health.

• My response: I do not support this proposal, as I think there should be a Wikipedia article about the specific topic of artificial control of the F- level in water for the intended purpose of improving dental health, and that is this article. However, others might support your suggestion. The way for you to go about this would be to start a requested move and explain your proposal, and there will be a discussion about how that will affect the article's scope. As an alternative, instead of doing this, consider creating a new article Water fluoridates, but be sure it does not duplicate or become a WP:POVFORK of this article.

• You appear to be suggesting that the existing article content (the opening sentences) "Water fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water has fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride." is misleading because of something in the York review, and that "that is effective" should be changed to "that is thought to be effective".

• My response: The article content you're quoting doesn't cite York, it cites the CDC. Are you saying the existing article content doesn't reflect the CDC's statement accurately? The CDC is unequivocal in its assertion that water fluoridation is effective. Or that the York review should be used in place of the CDC? Is there an argument being made that the York report should be considered more authoritative than the CDC? We need more clarity on what your suggestion is here.

• You appear to be suggesting adding more content on fluorosis.

• My response: Fluorosis is already covered well under Safety. What is missing? Sources for your suggested additional content?

• You are suggesting to add a "Total dietary fluoride load" section with the idea that fluoride is added because it is thought people are getting "too little dietary fluoride".

• My response: This suggestion doesn't seem to be based on what the sources say. As the article states, fluoride is not an essential dietary element, and its effect is topical and not systemic.

Feel free to correct where I may have misunderstood. Zad68 19:33, 27 February 2013 (UTC)

Agree, the authors do not use the term "poor" to describe the fluoride-reduces-caries aspect of their review. Per WP:MEDRS we do not base featured articles on press releases. Instead we should do as they recommend themselves: "we urge interested parties to read the review conclusions in full". And I suggest folk also read the existing Wikipedia article in full. And read the other cited reviews and sources too, for the York authors are not gods. The text could be clarified a little as I proposed above, but on the grand scale of things this is a small change. We have wasted enough time on this silly game, frankly. Colin°^Talk 20:09, 26 February 2013 (UTC)

OK, so I'm easily wearied. I admit it. I saw this controversy for the first time 1958 maybe, when I was student. The main thing that has changed since then is that nowadays the exchange of spittle more reliably starts with the second breath, sometimes with the first. The only reason I am here is the RFC. I suggest:

• Colin's suggested amendment looks like a good basis.
• List all the items or wording that it should not contain and does
• List all the items or wording that it should contain and does not
• Amend accordingly as necessary. If both lists are empty of substantial items, consider the process completed for now.
• Schluss until someone has something new and constructive to say (like "Say guys, have you seen this NEW, HIGH-QUALITY study?") and redirect off-topic nattering such as comparisons between the merits of water fluoridation and additives in toothpastes etc, to appropriate articles like Water fluoridation controversy. JonRichfield (talk) 12:24, 14 March 2013 (UTC)

Systemic Fluoride Intake vs. Topical Application to the Teeth

hatted per WP:NOTFORUM

Why does this article not discuss systemic effects of the fluoride on the human body (replacement of calcium in the bones making them brittle - fluorosis and thyroid supression)? What is the advantage or negative effect of fluoride in the drinking water vs. fluoride in toothpastes and mouthwashes? Why do we need fluoride in the drinking water, when it is already available in most toothpastes and many mouthwashes? Effect of fluoride on thyroid - fluoride used to be prescribed for overactive thyroid to reduce its activity. What is the effect of fluoride on a normal thyroid? What daily intake of fluoride should be deemed above dangerous levels? What fluoride dosages are commonly found in our tap water? — Preceding unsigned comment added by Poisonedwater (talk • contribs) 21:20, 6 March 2013 (UTC) "Fluoride was used as a drug to treat hyperthyroidism because it reduces thyroid activity quite effectively. This is due to the ability of fluoride to mimic the action of thyrotropin (TSH). Excess fluoride correlates with the other thyroid-related issues such as iodine deficiency. Fluorine and iodine, both being members of the halogen group of atoms, have an antagonistic relationship. When there is excess of fluoride in the body it can interfere with the function of the thyroid gland. Thus, fluoride has been linked to thyroid problems." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169868/ — Preceding unsigned comment added by 99.61.178.14 (talk) 21:54, 6 March 2013 (UTC) The prior therapeutic use of F to reduce thyroid hormone levels in cases of thyrotoxicosis is well documented (Goldemberg, (1926, 1930, 1932); May (1935, 1937); Orlowski (1932) and Galletti and G. Joyet, (1958)). — Preceding unsigned comment added by 99.61.178.14 (talk) 14:50, 8 March 2013 (UTC) What specific article content change are you suggesting, using what sources? Zad68 14:53, 8 March 2013 (UTC) The rationale for the systemic intake of fluoride from our water vs. just topical application of fluoride to teeth would be a good start. Are there advantages to systemic fluoride intake from water vs. application to teeth from dentifrice? Also recommended maximum safe daily systemic fluoride intake, and the approximate average systemic intake from fluoridated water and other fluoride sources in the USA. Poisonedwater (talk) 03:37, 12 March 2013 (UTC) You've missed the key points so let me emphasis them. What specific article content change are you suggesting, using what sources? TippyGoomba (talk) 05:09, 12 March 2013 (UTC) Even more specifically: using what RELIABLE sources? --Orange Mike | Talk 15:16, 12 March 2013 (UTC) What does that have to do with this article? It sounds to me like content for Water fluoridation controversy. Don't be greedy, one soapbox at a time please! JonRichfield (talk) 12:07, 14 March 2013 (UTC) Fluoride readily crosses the placenta. See "Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis" Fluoride readily crosses the placenta (Agency for Toxic Substances and Disease Registry 2003). "Fluoride exposure to the developing brain, which is much more susceptible to injury caused by toxicants than is the mature brain, may possibly lead to permanent damage (Grandjean and Landrigan 2006). The results suggest that fluoride may be a developmental neurotoxicant that affects brain development at exposures much below those that can cause toxicity in adults (Grandjean 1982). The estimated decrease in average IQ associated with fluoride exposure based on our analysis may seem small and may be within the measurement error of IQ testing. However, as research on other neurotoxicants has shown, a shift to the left of IQ distributions in a population will have substantial impacts, especially among those in the high and low ranges of the IQ distribution (Bellinger 2007)." — Preceding unsigned comment added by 99.61.178.14 (talk) 20:56, 6 April 2013 (UTC) Fluoridated water can cause kidney damage in children. See "The dose-effect relationship of water fluoride levels and renal damage in children". "Over 2.0 mg/L fluoride in drinking water can cause renal damage in children, and the damage degree increases with the drinking water fluoride content. Renal damage degree is not related to whether the children suffered from dental fluorosis and mainly due to water fluoride concentration." Fluoride may reduce Fertility Rates. See "Exposure to high fluoride concentrations in drinking water is associated with decreased birth rates". "A review of fluoride toxicity showed decreased fertility in most animal species studied. The current study was to see whether fluoride would also affect human birth rates. Most regions showed an association of decreasing TFR with increasing fluoride levels. There is no evidence that this outcome resulted from selection bias, inaccurate data, or improper analytical methods. However, the study is one that used population means rather than data on individual women." — Preceding unsigned comment added by 99.61.178.14 (talk) 00:42, 7 April 2013 (UTC) And at least one paper on PubMed links fluoride to Autism. See "A possible central mechanism in autism spectrum disorders...". "In addition, a number of environmental neurotoxins, such as FLUORIDE, lead, cadmium, and aluminum, can result in these pathological and biochemical changes." — Preceding unsigned comment added by 99.61.178.14 (talk) 00:59, 7 April 2013 (UTC) Yet another scattershot batch of inappropriate sources, either from questionable journals or outdated. As above see WP:MEDRS for Wikipedia's sourcing guidelines. Zad68 03:35, 7 April 2013 (UTC) Exactly what dates must they be? And can you please list the journals that you find "unquestionable"? — Preceding unsigned comment added by 99.61.178.14 (talk) 04:27, 7 April 2013 (UTC) I have a different objection. Your sources have nothing to do with the article, since they don't mention water fluoridation. TippyGoomba (talk) 04:37, 7 April 2013 (UTC) @TippyGoomba - At least three of the sources above are specifically discussing water fluoridation. Two others are regarding fluoride in general but may include fluoride in water. — Preceding unsigned comment added by 99.61.178.14 (talk) 05:18, 7 April 2013 (UTC) Fine, what edits are you suggesting? TippyGoomba (talk) 06:08, 7 April 2013 (UTC) @TippyGoomba - I'm still searching PubMed for more information but we were discussing Systemic Fluoride Intake vs. Topical Application to the Teeth. — Preceding unsigned comment added by 99.61.178.14 (talk) 06:46, 7 April 2013 (UTC)

Merge this article with "Water fluoridation controversy"

The article Water fluoridation controversy deals with the exact same subject, bears a wealth of reliable sources, and deals with the subject in a much more neutral way. The fact is that the entirety of continental Europe and East Asia all decry the use of fluoride in drinking water. Why is the fact that fluoridated water is illegal in half the world not even hinted at in this article? It seems the only reason these two articles are separated is to allow the one-sided authors of this article to make unequivocal claims about the safety & efficacy of fluoridated water. They achieve this agenda by delegating all the 'alternative' critical points of view to a different article.

This article should be stripped for the few bits of neutral claims which can be added to the Water fluoridation controversy article, then be deleted. If there continue to be unprincipled edits intended to reduce the validity of sourced claims, especially those intended to minimize the very significant criticisms against water fluoridation, this article needs to be protected and repeat offenders banned from editing it. It would not be outside the scope of reason to find that someone has been editing this article on direct behalf of an organization involved in selling fluoridation to municipal water supplies. Boleroinferno (talk) 19:48, 18 March 2013 (UTC)

Dream on. Colin°^Talk 20:41, 18 March 2013 (UTC)

Agreed. Water fluoridation and the controversy around it are two different topics, deserving their own articles as sources clearly show. I can't imagine how any attempt to conflate the two wouldn't be a FRINGE and NPOV violation. --Ronz (talk) 21:50, 18 March 2013 (UTC)

• Oppose They are separate topics, and this is a fully developed WP:FA quality article. Zad68 23:08, 18 March 2013 (UTC)

A bit like merging Kepler's laws of planetary motion into Flat earth. The comment suggest that the "Water fluoridation controversy" article doesn't make it obvious enough where the science falls. But the article looks fine to me. Am I mistaken? TippyGoomba (talk) 03:16, 19 March 2013 (UTC)

• Oppose on is a medical / scientific topic the other is a social movement. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:49, 19 March 2013 (UTC)
• Oppose I found the Water fluoridation controversy non-neutral and doesn't cover the scientific side. This article covers the topic well and neutrally.Ian Furst (talk) 22:12, 19 March 2013 (UTC)
• Comment. I do not think that editors need to respond to radical recommendations by timid drive-by conspiracy theorists. Unhappy editors come to this page regularly to espouse fringe views with lackluster sources. This activity has been ongoing for years. Almost none of these unhappy editors have an active talk page that would enable consensus-seeking conversations or collegial argumentation. So my point is that proposals - such as the present one about merging two mature articles - from these timid conspiracy theorists should be ignored or even deleted. There is no conversation with them to be had. --Smokefoot (talk) 01:26, 20 March 2013 (UTC)

The benefits are that the proposed change will clearly be shown not to have consensus, and also a future editor making a similar change proposal can be pointed to a long history of such proposals and how they've consistently been rejected. Also, we shouldn't WP:BITE, these proposals are coming from real live people who are (probably) making a good-faith effort to correct what they see as a problem, and so they should be given some respect. Besides, it only takes a few seconds to !vote appropriately for an obviously misguided proposal to an article you're familiar with. Zad68 04:10, 20 March 2013 (UTC)

The policy WP:BITE is intended to encourage greater tolerance by established editors to help WP recruit new editors. The anti-BITE policy in this case involves do-gooders (you, me) falling pray to evil doers: those with zero intention of editing, only seeking a soapbox. Their goal, rather successful, is to convert Talk pages into forums for fringe views. Their request for a change is invariably prefaced with some polemic - mission accomplished. I understand that my perspective does not present any nice directions forward. --Smokefoot (talk) 13:00, 20 March 2013 (UTC)

• Oppose The Water fluoridation controversy article is not neutral. I do not believe a single source makes for a reliable source that can be used here. We have an obligation to resist hyperbole in encyclopedia articles. — UncleBubba ^{( T @ C )} 06:32, 21 March 2013 (UTC)
• Oppose The two topics are different topics. And whichever of the various points of view one can take, this is the most blatantly juvenile POV tactic I have seen in a long time. Those who disagree with the proposer and fail to oppose it are passing up their duty; those who do agree and put up with having their views parodied in such a childish fashion, are doing their cause a disservice. JonRichfield (talk) 11:49, 21 March 2013 (UTC)

Shouldn't this article state what level of fluoride you should not exceed?

See "CDA Position on Use of Fluorides in Caries Prevention".

"...the total daily fluoride intake from ALL sources should not exceed 0.05-0.07 mg F / kg body weight". So as with most chemicals on which we rely (H2O, O2, C27H44O NaF/SnF2...), there is a range of intakes which are beneficial. Below or above that range there may be either no benefit, or harm. Communities considering water fluoridation are encouraged to review their individual circumstances carefully and in detail, giving attention to any available data on the dental health of community members, the size of the group not likely exposed to adequate fluoride from other sources, and the minimum level of fluoride required to be beneficial.

"Dental and public health administrators should be aware of the TOTAL fluoride exposure in the population before introducing any additional fluoride programme for caries prevention." (Fluorides and Oral Health, WHO, 1994). — Preceding unsigned comment added by 99.61.178.14 (talk) 01:55, 7 April 2013 (UTC)

"Most published reports show 1 to 5 milligrams of fluoride per liter of black tea, but a new study shows that number could be as high as 9 milligrams." Science Daily "Tea May Contain More Fluoride Than Once Thought, Research Shows". — Preceding unsigned comment added by 99.61.178.14 (talk) 02:35, 7 April 2013 (UTC)

The article already has content covering this. Zad68 03:39, 7 April 2013 (UTC)

Well it should also be noted that 41% of children between the ages of 12 and 15 years old in the USA have been overexposed to fluoride whether they live in fluoridated areas or NON-fluoridated areas. See CDC, "Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004".

It doesn't say that, it says "Prevalence of dental fluorosis was higher among younger persons and ranged from 41% among adolescents aged 12-15 to 9% among adults aged 40-49." The source makes no equivalence between fluorosis and 'overexposure.' There's no discussion of 'overexposure' on that page at all. Zad68 04:20, 7 April 2013 (UTC)

Do you understand that dental fluorosis is caused by overexposure to fluoride? See WebMD, "Fluorosis Overview". "It’s caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed."

Quite frankly, I'm confused as to what your objection to that is.

"overexposure" isn't defined, hence the quotes. Your suggested definition combined with the article you cite is a textbook case of WP:SYNTH. Also, what edit are you suggesting? TippyGoomba (talk) 05:01, 7 April 2013 (UTC)

@TippyGoomba - Dental fluorosis is a result of overexposure to fluoride. Overexposure to fluoride results in dental fluorosis. Its not difficult. I simply felt the article should state somewhere that the total daily fluoride intake from ALL sources should not exceed 0.05-0.07 mg F / kg body weight. This would be helpful given the rate of dental fluorosis in the USA. Furthermore some people may not be aware of the high levels of fluoride found in black tea. — Preceding unsigned comment added by 99.61.178.14 (talk) 05:27, 7 April 2013 (UTC)

"The article already has content covering this" TippyGoomba (talk) 06:07, 7 April 2013 (UTC)

CLAIMED: There is no difference in tooth decay rates in fluoridated versus non-fluoridated areas

See http://pubs.acs.org/doi/pdf/10.1021/cen-v067n019.p005

"An analysis of national survey data collected by the National Institute of Dental Research (NIDR) concludes that children who live in areas of the U.S. where the water supplies are fluoridated have tooth decay rates nearly identical with those who live in nonfluoridated areas."

Chem. Eng. News, 1989, 67 (19), pp 5–6 DOI: 10.1021/cen-v067n019.p005 Publication Date: May 08, 1989 Copyright © 1989 AMERICAN CHEMICAL SOCIETY — Preceding unsigned comment added by 99.61.178.14 (talk) 17:17, 8 April 2013 (UTC)

Really, a 1989 article by the American Chemical Society? After you posted your last batches of sources, I assumed good faith and carefully reviewed each one, explained how they did not meet Wikipedia medical sourcing guidelines, and pointed you to WP:MEDRS so that you could learn how to identify useful sources. You followed that up with a declaration indicating your involvement here is in opposition to WP:NOTADVOCACY, and now you're bringing more inappropriate sources, without any clear suggestion for the article.

I recommend that nobody bother with these bad-faith source dumps. Zad68 17:25, 8 April 2013 (UTC)

It is regarding the largest study ever undertaken regarding tooth decay in fluoridated versus non-fluoridated areas but you find it insignificant? Your motives are quite telling. — Preceding unsigned comment added by 99.61.178.14 (talk) 17:36, 8 April 2013 (UTC)

Oh riiight! Bigger means better? Grow up! Any idiot who is willing to ask the wrong questions can get any answer he pleases to any study, big or small. Did you see who ran the study? Do me a favour! JonRichfield (talk) 18:30, 8 April 2013 (UTC)

@JonRichfield - Yiamouyiannis obtained the survey data from NIDR under the Freedom of Information Act.

It's clear you don't understand. Read PROCEEDINGS Fourth Annual Conference of State Dental Directors with The Public Health Service and The Children's Bureau, June 6-8, 1951; Federal Security Building, Washington, D.C..

This is the United States Government documentation of the minutes of a meeting sponsored by the U. S. Public Health Service in regards to the “Promotion and Application of Water Fluoridation.” Thesetminutes are officially recorded in Volume #5 of Hearings, 89th Congress, Dept. of Labor and Health Education and Welfare Appropiations for 1967. They are also recorded, Case #8425, Exihibit 108, of Public Utilities Commission of Calif. 1966. Its the infamous U.S. Dental Conference, 1951 with the "missing" minutes. I'm sure you'll find it interesting. — Preceding unsigned comment added by 99.61.178.14 (talk) 21:12, 8 April 2013 (UTC)

Clearly you're not getting support for this. Got any better references? TippyGoomba (talk) 02:44, 9 April 2013 (UTC)

As an outsider to this conversation, I am curious as to learning more about why this article is unreliable per WP:MEDRS. It seems to me that the ACS would have a conflict of interest in favor of water fluoridation, if anything, but I am not particularly familiar with them. I also have not seen the IP's declaration "indicating that his/her involvement here is in opposition to WP:NOTADVOCACY", but I would take care to note that being personally opposed to water fluoridation cannot instantly qualify as a violation of WP:NOTADVOCACY unless personally supporting water fluoridation is a violation of WP:NOTADVOCACY. Perhaps the IP believes that the article does not adhere to WP:NPOV but is not expressing this. Lastly, does the source presented not immediately disprove that this is scientific consensus: "Water fluoridation is effective at reducing cavities in both children and adults"? Thanks, Gold Standard 03:10, 9 April 2013 (UTC)

it's out of date, see WP:MEDDATE. Also, it meets none of the criteria of This page in a nutshell: Ideal sources for biomedical material include general or systematic reviews in reliable, third-party, published sources, such as reputable medical journals, widely recognised standard textbooks written by experts in a field, or medical guidelines and position statements from nationally or internationally recognised expert bodies. TippyGoomba (talk) 03:52, 9 April 2013 (UTC)

Got it, that clears things up. One last thing, assuming the source was recent, why wouldn't the ACS be considered a "reliable, third-party, published source"? Gold Standard 04:06, 9 April 2013 (UTC)

The same reason you don't see any theological scholarship in the evolution article, it's not a medical journal. It may be that the journal is a reliable source, just not for medical claims. TippyGoomba (talk) 04:10, 9 April 2013 (UTC)

I see, I hadn't considered that. Is it specifically a medical claim, though? It seems to me that the ACS would not have published a study if it was not related to their area of study. Could this claim not be considered both a medical claim and a claim relating to chemicals? For example, would a study from the ACS identifying a certain chemical as damaging to the eyes not be considered reliable when writing about that chemical? Gold Standard 04:19, 9 April 2013 (UTC)

I could imagine not needing a WP:MEDS citation for the fact that putting lye in my eyes is harmful. But it's hard to think of an example where we'd wish to discuss such effects, not be able to find a meds source, and require a source in the first place (see WP:BLUE). I'm fairly certain the example I gave fits none of these criteria. TippyGoomba (talk) 06:51, 9 April 2013 (UTC)

So a meds citation is only necessary for controversial claims (e.g. that sodium fluoride doesn't actually slow tooth decay)? Gold Standard 07:17, 9 April 2013 (UTC)

Yes, except I would replace "controversial" with WP:EXCEPTIONAL. Also, I would apply it more broadly, to all of science and history at the very least. There's nothing special about meds in this case, it's simply that meds has some unusual requirements like 5 year systematic reviews. TippyGoomba (talk) 08:07, 9 April 2013 (UTC)

Cool, thanks for your help! It's always good to learn and understand more of Wikipedia's policy as it applies to real scenarios. Hopefully our conversation helps the IP too if he/she reads this. Gold Standard 08:31, 9 April 2013 (UTC)

Evidence-basis

"Fluoride's caries-preventive properties initially were attributed to changes in enamel during tooth development because of the association between fluoride and cosmetic changes in enamel and a belief that fluoride incorporated into enamel during tooth development would result in a more acid-resistant mineral. However, laboratory and epidemiologic research suggests that fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are TOPICAL for both adults and children "

"Achievements in Public Health, 1900-1999..".

This deserves at least a mention somewhere in this article. — Preceding unsigned comment added by 99.61.178.14 (talk) 19:48, 9 April 2013 (UTC)

And amazingly enough it already is in the article. Zad68 19:55, 9 April 2013 (UTC)

STATEMENT OF Dr. J. WILLIAM HIRZY of the EPA

STATEMENT OF Dr. J. WILLIAM HIRZY.

Why is this completely omitted in this article?

Dr. J. William Hirzy of the EPA states, "Kingston and Newburg, New York Results- In 1998, the results of a fifty-year fluoridation experiment involving Kingston, New York (un-fluoridated) and Newburg, New York (fluoridated) were published (17). In summary, there is NO overall significant difference in rates of dental decay in children in the two cities, but children in the fluoridated city show significantly higher rates of dental fluorosis than children in the un-fluoridated city."

He further states, "a massive experiment that has been run on the American public, without informed consent, for over fifty years".

Does Wikipedia consider this insignificant? — Preceding unsigned comment added by 99.61.178.14 (talk) 20:15, 9 April 2013 (UTC)

Dr. William L. Marcus of the EPA is considered a "whistle-blower" concerning government policy regarding fluoridation. It was in the Washington Post on March 1, 1994. See Washington Post Article, "Whistle-Blower Clears the Air" dated March 1, 1994.

Why is this ignored in this article? — Preceding unsigned comment added by 99.61.178.14 (talk) 21:32, 9 April 2013 (UTC)

Perhaps a statement about Dr. Marcus' or Dr. Hirzy's position on the matter could be added to the Water_fluoridation#Ethics_and_politics section or to the Water fluoridation controversy article, but it could not be used to state that "there is NO overall significant difference in rates of dental decay in children in the two cities". To place this claim into the article, you need a reliable medical source that is less than 5 years old per WP:MEDDATE. Thanks for understanding, Gold Standard 01:17, 10 April 2013 (UTC)

Also, the Washington Post is not a reliable source for this claim, see WP:MEDS. TippyGoomba (talk) 02:55, 10 April 2013 (UTC)

It would be acceptable for putting a statement about Dr. Marcus' position on the matter, although I'm not so sure that's what the IP wants. Gold Standard 03:03, 10 April 2013 (UTC)

The IP isn't even bothering to make a suggestion about article content here, but rather is only making pointed questions about the motives of Wikipedia editors: "Why is this completely omitted in this article?" "Does Wikipedia consider this insignificant?" "Why is this ignored in this article?". This is more evidence demonstrating WP:AGF would be misplaced. Zad68 03:08, 10 April 2013 (UTC)

I think the IP is genuinely concerned about the bias that he/she perceives in this article, but has not educated him or herself well enough on Wikipedia policies. Gold Standard 03:53, 10 April 2013 (UTC)

You're welcome to continue to WP:AGF but I've seen enough evidence to the contrary (as the AGF guideline allows). Zad68 03:56, 10 April 2013 (UTC)

I will continue to WP:AGF as I see little evidence to the contrary. The IP's questions, although accusatory of the motives of other editors, do not evidence bad faith. In fact, since the IP is attempting to remedy a perceived bias on this page, the IP is seeking to improve Wikipedia (albeit without much of an understanding of Wikipedia policy). Gold Standard 04:50, 10 April 2013 (UTC)

Dr. Marcus isn't a reliable source either, which is why we have peer review. TippyGoomba (talk) 03:20, 10 April 2013 (UTC)

If you look at the footnotes on this article, MOST of the medical information it contains is older than five years old and may need to be removed if you are going to adamantly require WP:MEDDATE of less than 5 years on everything. Of course if you plan to cherry-pick, that would be a different matter. The whole article comes off as very biased in general. What makes Dr. Marcus unreliable? Is it simply his POV? — Preceding unsigned comment added by 99.61.178.14 (talk)

Sigh, i meant to cite WP:MEDRS and not WP:MEDS. Anyway, WP:MEDRS says we require peer-reviewed literature. TippyGoomba (talk) 04:46, 10 April 2013 (UTC)

Why was my signature copied? This was the IP: [1] Gold Standard 04:50, 10 April 2013 (UTC)

Sorry about that. TippyGoomba (talk) 05:04, 10 April 2013 (UTC)

No worries. Gold Standard 05:26, 10 April 2013 (UTC)

But we don't need peer-reviewed safety studies on consuming and bathing in water with added hexafluorosilicic acid? Its not the same as naturally occurring "calcium fluoride" yet it is added to tap water and simply called "fluoride". It doesn't even have the same LD50 toxicity level as "calcium fluoride". Unfortunately, I'm unable to find any peer-reviewed safety studies on it. But Wikipedia considers that okay? — Preceding unsigned comment added by 99.61.178.14 (talk)

I would be inclined to ask why you think that your LD50 figures are relevant, but you make it difficult to believe that you have any idea. You might have a point if this article had anything to do with possible accidents in which the population might be exposed to something like 100 (putting it charitably) times the required dosage, (always on the assumption that the 70mg/kg applied directly to humans, and under circumstances where essentially the whole F content of the water remained unchanged in form and quantity, from the point of introduction) but the debate is supposed to be about the benefits or otherwise of applying less than 1ppm of soluble fluoride in drinking water. Work out what that might suggest in mg/kg body weight. Now, if they were proposing xenon fluorides instead of hexafluorosilicate, you might have a point... JonRichfield (talk) 20:09, 10 April 2013 (UTC)

@JonRichfield - From what I understand, calcium mitigates the toxicity of fluoride compounds. This is why calcium of some form is used as an antidote in fluoride overdose or toxicity. And this is why calcium fluoride is considered the least toxic of fluoride compounds. Furthermore calcium fluoride is much less likely to dissociate in water as does hexafluorosilicic acid. There's quite a bit of difference in these compounds. I don't believe there is any calcium in hexafluorosilicic acid which is why I believe peer-reviewed safety should be required before any claims of safety can be made. Hexafluorosilicic acid can be used as a pesticide and rodenticide. Calcium fluoride does not make an effective pesticide due to its calcium content. I believe most medications are required to have peer-reviewed safety studies done on them. If there are any specific peer-reviewed safety studies on the use of hexafluorosilicic acid, I believe they should at least be mentioned and cited somewhere in this article. As stated before, hydrofluorosilicic acid (also known as hexafluorosilicic acid) was banned by the EU in 2006 due to lack of toxicological data to show it was safe for humans and the environment yet this banned chemical is used to fluoridate the water in the USA. Correct me if I'm wrong.

If you want to discuss it, create a new section and describe the issue more carefully. I don't quite follow what you're saying. TippyGoomba (talk) 05:04, 10 April 2013 (UTC)

Dr. Colquhoun a dentist of New Zealand says data was "doctored"

Shouldn't this be mentioned in an article regarding water fluoridation?

See AFFIDAVIT OF DR. JOHN COLQUHOUN IN SUPPORT OF MOTION FOR SUMMARY JUDGMENT.

"I was shocked to discover, when the statistics were sent to me, they revealed no such benefit. In fact, in most Health Districts the percentage of children who were "caries-free" was higher in the non-fluoridated areas than in the fluoridated areas. I disagreed sharply with my superiors' action in circulating a document, "overview of fluoridation statistics," which omitted the above information, disgracefully 'doctored' the remaining statistics, and claimed that a marginal benefit existed." — Preceding unsigned comment added by 99.61.178.14 (talk) 00:55, 10 April 2013 (UTC)

No, see WP:MEDS. An affidavit is not a journal article. TippyGoomba (talk) 03:21, 10 April 2013 (UTC)

His statements are also in a journal article. "Why I changed my mind about water fluoridation". Colquhoun, J. Perspectives in Biol. And Medicine 41 1-16 (1997). — Preceding unsigned comment added by 99.61.178.14 (talk) 04:13, 10 April 2013 (UTC)

Old, an opinion piece, and WP:FRINGE. TippyGoomba (talk) 04:23, 10 April 2013 (UTC)

On a separate note, would it not be acceptable to write a statement in the opposition paragraph specifically about this Doctor's views? or is he not notable enough? Gold Standard 04:35, 10 April 2013 (UTC)

We'd need a good quality secondary source to establish this guy's opinion is notable. Zad68 04:43, 10 April 2013 (UTC)

Agreed. Gold Standard 04:45, 10 April 2013 (UTC)

Dr. J. Colquhoun has several papers on PubMed regarding fluoridation but it doesn't look like abstracts are available to read. — Preceding unsigned comment added by 99.61.178.14 (talk) 04:48, 10 April 2013 (UTC)

Dr. J. Colquhoun is also used as a reference in "Fluoride in Drinking Water: A Scientific Review of EPA Standards (2006), Board of Environmental Studies and Toxicology".

"Others claim that fluoride causes various adverse health effects and question whether the dental benefits outweigh the risks (Colquhoun 1997)." — Preceding unsigned comment added by 99.61.178.14 (talk) 05:17, 10 April 2013 (UTC)

Those are primary sources, what about secondary sources? TippyGoomba (talk) 05:21, 10 April 2013 (UTC)

@TippyGoomba - "Fluoride in Drinking Water: A Scientific Review of EPA Standards" (2006) is a "secondary" source. Its a book on fluoride. — Preceding unsigned comment added by 99.61.178.14 (talk) 18:43, 10 April 2013 (UTC)

Please provide the specific article content change you are proposing (provide the exact wording you are requesting and specify which section of the Wikipedia article you are proposing to change), and name the exact source you are proposing to use to support it, including page numbers. Zad68 19:02, 10 April 2013 (UTC)

Notice to IP editor 99.61.178.14

IP editor 99.61.178.14, I have left you a request to adhere to WP:TPG and WP:MEDRS at your talk page here. I am leaving you this note here in case your IP changes. Zad68 03:50, 10 April 2013 (UTC)

Recent revert

Below is material copied from my talk page; I felt this thread is more appropriately discussed here:Yobol (talk) 03:55, 10 April 2013 (UTC)

Hello Yobol,

Would you mind explaining your revert of my edit? I do not understand it simply based on your edit summary.

Thanks,

Gold Standard 03:38, 10 April 2013 (UTC)

Sorry, my edit summary was incomplete. What I meant to say is we don't inline attribute to the journal title like you proposed; first, attribution would be to the author if it was necessary, but is unnecessary for uncontentious material. Attribution, when unnecessary, makes it appear that only that source is making that claim and makes it appear like less the generally accepted principle that it should be presented as. Yobol (talk) 03:42, 10 April 2013 (UTC)

Isn't "highly misleading picture" clearly contentious material, given that it is being used to describe opposition? Also, could you please explain the two other changes I made that you reverted? Gold Standard 03:47, 10 April 2013 (UTC)

It is not contentious as the scientific/medical consensus is that the arguments against water fluoridation are spurious. Inline attributing to the source makes it appear as if only that source feels that way, when that is not (or really shouldn't be) a contentious point. I have no strong opinion about the order of the paragraphs, though I note that the current sequence is not out of order as conspiracy theories are a big driver of the opposition to fluoridation. Yobol (talk) 03:55, 10 April 2013 (UTC)

Then would it not be correct to say, "opposition that, according to scientific and medical consensus, ..."? Also, the water fluoridation controversy article is opposed to your last statement. It says that "moral, ethical, political, and safety concerns" are the main drivers of the opposition. It seems to me that the conspiracy theory paragraph interrupts the paragraph on opposition in general and the paragraph describing the types of people who are opposed. Lastly, I am strongly opposed to your edit removing the list of names. Listing those names adds detail to the paragraph. Also, it is certainly notable that a nobel prize winning scientist is among the opponents. Gold Standard 04:01, 10 April 2013 (UTC)

No, there is no need to attribute it. We don't say "According to the scientific consensus, HIV causes AIDS" just because there are a few denialists who try to create a controversy where there really is none. We just plainly state "HIV is the cause of AIDS" - no attribution necessary. The controversy article is in a horrible state, and I wouldn't use that as an example for anything to strive for, or, frankly, for accurate information. Lastly, I do not mind a mention of notable opponents of fluoridation; however, mention would need to come from an independent reliable secondary source that demonstrates that opponent's notability in the context of their fluoridation views. Yobol (talk) 04:06, 10 April 2013 (UTC)

Even the section that we are working on declares that there are other (arguably more) major contributors to opposition to water fluoridation. The Nobel Prize winning scientist, for example, is opposed for ethical reasons. Also, if you do not mind a mention of notable opponents of fluoridation, why did you delete the sourced list that was already there? Arvid Carlsson is a Nobel Prize winning scientist; he is perfectly notable because his statement is against mass medication. One does not have to have done work with fluoride to be opposed to mass medication. In fact, he is perfectly notable for this because he serves as an example of someone who holds an ethical argument against fluoridation. Gold Standard 04:23, 10 April 2013 (UTC)

Find an independent, reliable, secondary source that mentions that Carlsson is important to the ethics of water fluoridation, and I would not object to it going back in. 04:34, 10 April 2013 (UTC)

How can someone be "important to the ethics of water fluoridation" except by being an advocate for ethics in public policy on mass medication? The references I took from Carlsson's article do perfectly well at demonstrating Carlsson's stance and action taken on his stance. Gold Standard 04:42, 10 April 2013 (UTC)

If he is well known and discussed in reliable, independent secondary sources as an important contributor to the discussion of ethics of water fluoridation, it can go in. Not all views of every Nobel winner deserves mention on Wikipedia; only the significant ones as documented by independent reliable sources. Yobol (talk) 04:44, 10 April 2013 (UTC)

Ok, I will add him back using this source: [2] (readable thanks to Google Translate). I will also flip the paragraph order while I'm at it. Gold Standard 04:59, 10 April 2013 (UTC)

I don't agree to the singling out by name of Carlsson using an individual newspaper article, when the rest of the types of opponents listed come from a chapter in a book by CDC epidemiology program director John W. Ward, and Professor of History Christian Warren at the NY Academy of Medicine. The Svenska Dagbladet doesn't come close to the authority of the book on this subject, so naming Carlsson (and nobody else) in this way is a problem with WP:UNDUE. If individuals are to be named, we should instead use the individuals named in the book chapter: Gladys Caldwell who opposed on environmental concerns, and Ralph Nader on questioning the use of public funds. Zad68 13:01, 10 April 2013 (UTC)

Adding: We may consider using this book: link. Here's a review of the book in the British Dental Journal: link. This book is far better than an individual newspaper article but I'm only lukewarm about using it, as I'm not convinced the authority of it is quite in the same ballpark as the book the article currently uses. Zad68 13:18, 10 April 2013 (UTC)

I agree, would you like me to do it? Gold Standard 00:21, 11 April 2013 (UTC)

I guess you're agreeing that we shouldn't take action using just Svenska Dagbladet? I'm not yet advocating any action to add Carlsson to the article. I see the good sense in just discussing the antifluoridation efforts by groups and not individuals. Zad68 02:08, 11 April 2013 (UTC)

Sure, why only rely on a single source when we have others? Also, Carlsson is a very prominent and active figure in the ethical discussion of fluoride. The minority viewpoint here is not that small, so it would be undue weight in the other direction to omit the mention of prominent figures who are opposed to water fluoridation. Gold Standard 04:00, 11 April 2013 (UTC)

Yobol's dead on here. Also would like to point out that this article is WP:FA and water fluoridation controversy isn't even WP:GA so I wouldn't be looking at that article as the standard to compare this one against. Zad68 04:08, 10 April 2013 (UTC)

Conspiracy theories involving fluoridation are common?

What does the statement "Conspiracy theories involving fluoridation are common" mean? Certainly they are not common among the general public. And from where is it sourced? Gold Standard 05:35, 10 April 2013 (UTC)

You should aggressively remove stuff like that. If you think a source can be found, add a {{citation needed}} tag instead. Worst case scenario, someone reverts and we end up here anyway, check out WP:BRD :) TippyGoomba (talk) 06:25, 10 April 2013 (UTC)

Done! Gold Standard 07:10, 10 April 2013 (UTC)

Actually, take a look at the source. That statement was taken directly out of it. Can this source be trusted? [3] Gold Standard 07:16, 10 April 2013 (UTC)

That source and its use of it look OK to me. Zad68 15:36, 10 April 2013 (UTC)

"Conspiracy theories involving fluoridation are common" has no meaning. Does a large percentage of the population really believe in fluoridation conspiracies? In what part of the world is this statement addressing? Are they common amongst people in the US, or all over the world? The statement is as ambiguous as it is nonsensical. Gold Standard 00:24, 11 April 2013 (UTC)

I'm finding no issue with the plain meaning of the source. It means just what it says: when you review antifluoridation literature, in addition to seeing cherry-picking of studies, ignored evidence, and fear mongering, it's not unusual to find conspiracy theories. It's an important point. Read the whole Health Policy article to understand the context of the sentence. I don't see a reason to remove this from the article. Zad68 02:04, 11 April 2013 (UTC)

You are missing my point. I'm not saying that the point made in the source is ambiguous. The statement made in the article, which does not come across as the same point, is ambiguous and nonsensical in the context of the article: "Conspiracy theories involving fluoridation are common, and include claims that fluoridation was motivated by ..." Common amongst who? People reading this are not going to know what to think. Gold Standard 03:58, 11 April 2013 (UTC)

@Zad68 Regarding John Birch Society Reference

I believe I may have determined the reason that the John Birch Society was listed under opposition:

In 1992, libertarian theorist Murray Rothbard reprised the Covert Action story in an article for the John Birch Society-affiliated magazine The New American. In that article Rothbard wondered, "It has always been a bit of a mystery to me why left-environmentalists, who shriek in horror at a bit of Alar on apples, who cry 'cancer' even more absurdly than the boy cried 'Wolf,' who hate every chemical additive known to man, still cast their benign approval upon fluoride, a highly toxic and probably carcinogenic substance." [4]

Original article link: [5] — Preceding unsigned comment added by Gold Standard (talk • contribs)

The reference to the John Birch Society was originally added in this edit from January 2009 by Eubulides, the main editor of this article who developed it to WP:FA standard (listed as FA in June 2009), source at that was the same Reason article you cited. Between January and June that reference to the Reason article was removed and replaced with the book The Fluoride Wars which I see does indeed support the John Birch mention. So I'll put that back now that we've got the source identified.

And, by amazing co-incidence, check this out, that same edit removed the the mention of Carlsson by name! The edit summary says "Focus on today and on group issues, instead of on actors in long-ago events." I see the point of this. I'm still not very keen on adding in Carlsson by name. Zad68 01:48, 11 April 2013 (UTC)

Requested variance on reliable sources (medicine) for water fluoridation

"Human Toxicity, Environmental Impact and Legal Implications of Water Fluoridation" (Technical Report) February 2012.

Please do not intimidate or go on the attack. I'm just asking. — Preceding unsigned comment added by 99.61.178.14 (talk • contribs)

Would it be too much to ask you to please sign your posts. All you have to do at the end of your posts it to type four tildes like this: ~~~~. Everybody else does it, could you please do it too.

Here's the deal with mentioning sources: You can't just mention a source, you have to also specify content you are proposing using the source. No source is always good for all uses, no source is always bad for all uses. Sources don't exist by themselves, you have to specify the article content using it.

What is the article content you are proposing using this source? Zad68 02:13, 11 April 2013 (UTC)

Adding: This report is the self-published monograph of Declan Waugh. It really can only be used to source statement of Mr. Waugh's own opinion, and nothing has been provided at all to establish that Waugh's opinion is notable enough for inclusion here. You haven't read WP:MEDRS it appears. Zad68 02:21, 11 April 2013 (UTC)

@Zag - I've read WP:MEDRS but unfortunately you and I don't interprete it the same way. It also says, "When reliable sources disagree, present what the various sources say, give each side its due weight, and maintain a neutral point of view." — Preceding unsigned comment added by 99.61.178.14 (talk) 02:40, 11 April 2013 (UTC)

What you gave isn't a reliable source. TippyGoomba (talk) 02:46, 11 April 2013 (UTC)

Regarding "Reliable Sources" it says "The fact that a statement is published in a refereed journal does not make it true. Experiments and other studies have fallen victim to deliberate fraud. (See: Retracted article on neurotoxicity of ecstasy, and Schön affair.)" "Make readers aware of any uncertainty or controversy. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers."

Why can't we report and remain neutral on this topic given all the controversy? — Preceding unsigned comment added by 99.61.178.14 (talk) 03:03, 11 April 2013 (UTC)

A lengthy discussion is already in the article under Ethics and politics. Once again, what content change are you proposing? Zad68 03:06, 11 April 2013 (UTC)

I think there should be another section regarding the current opposing views of water fluoridation with the names of those opposed to it, highlighting why they each oppose it with citations. Allow the readers enough information to form their own opinion if they wish. It isn't all that difficult and it can be done in a neutral way. That way the article doesn't come off as being severely biased which is what I think most people are opposed to anyway. — Preceding unsigned comment added by 99.61.178.14 (talk) 03:27, 11 April 2013 (UTC)

Arguments raised by opponents are already given. No supporters of fluoridation are specified by name. Why should opponents be specified by name? Zad68 03:36, 11 April 2013 (UTC)

@Zad - If you want to list the supporters by name, I think that would be a great idea. Why not? — Preceding unsigned comment added by 99.61.178.14 (talk) 03:44, 11 April 2013 (UTC)

Seems like a really bad idea. Articles on a given topic would have a list of people that support the concept and those that dont? Unworkable. These articles are not forums. It is an encyclopedia. --Smokefoot (talk) 03:56, 11 April 2013 (UTC)

(e/c to say the same thing) Because there'd be far too many of them, and it'd be WP:UNDUE weight to highlight attention on individuals like that when the important topic is the groups that support. It'd also be a WP:GEVAL problem. Zad68 03:58, 11 April 2013 (UTC)

We could just limit the names to 10 or 15 of those most outspoken for or against water fluoridation. There is no need to make it difficult. And just keep it neutral. I don't see a major problem with it.

Why don't objectors to these fluoridation articles register?

Strange that those that find this article so objectionable are almost always unregistered. Why are these editors so disinclined to describe themselves. Why this trend - paranoia? disinterest? Anti-collegiality?--Smokefoot (talk) 04:02, 11 April 2013 (UTC)