Talk:Water fluoridation
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Which Green parties?
A recent edit replaced "Green Party" with "New Zealand Green Party". However, the cited source (Nordlinger 2003) mentions the Green Parties of both New Zealand and the United Kingdom. Shouldn't the phrase be replaced instead with something like "New Zealand and UK Green parties"? Eubulides (talk) 00:59, 12 October 2009 (UTC)
- There is no UK Green party. If you can find a source as to whether it was the Green Party of England and Wales, the Scottish Green Party, or the Green Party in Northern Ireland, then by all means add it. jnestorius(talk) 01:15, 12 October 2009 (UTC)
- I can easily find reliable sources showing that all three of those Green parties oppose water fluoridation. However, this article is not the place to publish a list of Green party organizations that oppose water fluoridation. Rather than list individual organizations I'm inclined to rewrite the text to say something like "Green parties in the UK and New Zealand", which (1) is correct (if I've got the wording/punctuation right) and (2) is directly supported by the cited source. How does that sound? Eubulides (talk) 04:35, 12 October 2009 (UTC)
- That's fine. I didn't like the unqualified link to Green party, as not all such parties oppose fluoridation. jnestorius(talk) 13:13, 12 October 2009 (UTC)
- OK, thanks, I did that. Eubulides (talk) 07:03, 13 October 2009 (UTC)
Article order
Small question, why is the History section at the very bottom? Wouldn't it make stylistic sense to have that up top? Staxringold talkcontribs 02:15, 12 October 2009 (UTC)
- It's common in many technical articles to put History later in the article, using the idea that most readers are interested in the current state of a subject more than in historical aspects. See, for example, Autism, Asperger syndrome, Saffron (all featured articles). Eubulides (talk) 04:13, 12 October 2009 (UTC)
Secondary article on Opposition should be merged
Why is there a second article on fluoride opposition? It seems to duplicate several sections of this article. Criticism has been moved to a different article where it can still be countered without admitting it has the validity of the main article. Valid criticisms should be included in this article. If any one section of this article was deserving of a separate section, that would make sense, but a separate article that tracks several sections is just leading to a silence of criticism and duplicate information. —Preceding unsigned comment added by Gregwebs (talk • contribs) 04:29, 12 October 2009 (UTC)
- It is common for articles that would otherwise be too long to split off subarticles for particular subtopics, and I expect that is what has happened here. Water fluoridation is a featured article and covers the entire subject; its Ethics and politics section briefly covers the controversy neutrally and at a high level. The subarticle Opposition to water fluoridation goes into considerably more detail. Unfortunately the subarticle has serious NPOV and reliability problems, some of which are noted by its tags. Among other things, the subarticle's very title is wrong: it should be Water fluoridation controversy and it should present all sides of the controversy neutrally, which it currently does not. But at any rate, these are problems with the subarticle, not with Water fluoridation itself. Eubulides (talk) 04:48, 12 October 2009 (UTC)
- Yes, but that article is not a subarticle. It is a listing of critiques across various sections of the main article. It is a problem with this article that proper criticism is being placed on a separate page instead of being addressed. Gregwebs (talk) 06:20, 12 October 2009 (UTC)
- It is true that the opposition article is poorly written and organized, but the point is that the criticism is summarized and addressed here. This is not the place to list in detail every argument against water fluoridation, just as the Cancer article isn not the place to list every treatment against cancer. It suffices here to briefly summarize the arguments, in proportion to the weight given them by reliable sources. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- Yes, but that article is not a subarticle. It is a listing of critiques across various sections of the main article. It is a problem with this article that proper criticism is being placed on a separate page instead of being addressed. Gregwebs (talk) 06:20, 12 October 2009 (UTC)
Essential Nutrient
The previous discussions on this subject were interesting, but based on original research of what an essential nutrient is. None of the cited sources state that fluoride is an essential nutrient. WP does not list it as essential nutrient. There is no need to quote (and not show that we are quoting) their ridiculous wordplay on Wikipedia to give the impression that it could be essential when there is no evidence to back up those statements. Speculation should be explicitly labeled as such. —Preceding unsigned comment added by Gregwebs (talk • contribs) 04:52, 12 October 2009 (UTC)
- The coverage that's currently in Water fluoridation is directly supported by the cited sources, and is not original research. The first cited source, Olivares and Uauy 2005 (PDF), says "The essentiality of fluoride for humans has not been proven unequivocally", which is pretty much what Water fluoridation currently says. The same source goes on to say "However, this element has beneficial effects on the prevention of dental caries" which is pretty much the same point that all reliable sources on this topic say: namely, that fluoride has a beneficial effect even if it's not an essential nutrient. This point is elaborated further by the second source, Jones & Varady 2008 (PMID 18347661), which provide dietary fiber as helpful example of another nutrient that has beneficial effects but is not essential. This discussion is highly relevant to fluoride and is well supported by reliable sources, with no serious dispute about it in reliable sources; I see no reason to remove the discussion, though of course there is always room for improvement in the coverage of any topic. Eubulides (talk) 05:06, 12 October 2009 (UTC)
- The current material is being directly quoted (and not shown as such). So if you are going to continue to revert my edits which are consistent with Wikipedia's guidelines, an alternative that does not violate those guidelines should be provided. Gregwebs (talk) 06:14, 12 October 2009 (UTC)
- It's not supposed to be a direct quote: it's supposed to be a close paraphrase. In a controversial area like this, it's wise to not stray too far from the sources. If there is any real objection to it based on direct quotation, please specify the objectionable words. Wording we can fix. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- The current material is being directly quoted (and not shown as such). So if you are going to continue to revert my edits which are consistent with Wikipedia's guidelines, an alternative that does not violate those guidelines should be provided. Gregwebs (talk) 06:14, 12 October 2009 (UTC)
- I don't think a discussion about the definition of an essential nutrient belongs on this page, it belongs on the essential nutrient page. A citation of someone proposing a new definition of essential nutrient that could possibly include fluoride just proves that point. I don't see why we need to make this speculation part of this page without labeling it as such. Gregwebs (talk) 06:14, 12 October 2009 (UTC)
- The article text in question does not propose a new definition of essential nutrient; it uses the traditional definition. We cannot expect the typical reader to know the distinction between a nutrient and an essential nutrient (which is the main distinction here). The question of whether fluoride is an essential nutrient or just a nutrient is an important one, supported by many reliable sources (not just the sources listed here). It's inappropriate to unilaterally remove this longstanding material over reasonable objections. Please restore it while we thrash out the wording on the talk page. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- I don't think a discussion about the definition of an essential nutrient belongs on this page, it belongs on the essential nutrient page. A citation of someone proposing a new definition of essential nutrient that could possibly include fluoride just proves that point. I don't see why we need to make this speculation part of this page without labeling it as such. Gregwebs (talk) 06:14, 12 October 2009 (UTC)
- My suggestion is to avoid copying pro-fluoride speculation and to state the facts: "Fluoride is not considered an essential nutrient in the sense of being required to sustain life or growth in humans. A diet low in sugar removes the need for fluoride." Gregwebs (talk) 15:17, 12 October 2009 (UTC)
- The existing article text in question does not contain speculation, either pro- or anti-fluoride. And the existing text states all the facts given in your proposal. No valid reason has been given to remove the material in question, which is well-supported by reliable sources. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- The text "It has not been proven unequivocally whether fluoride is an essential nutrient" contains quoted weasel words with the goal of making it sound like fluoride is probably an essential nutrient. Keeping this obtuse wording is not required for an accurate summary of the facts at hand. Gregwebs (talk) 19:59, 12 October 2009 (UTC)
- The cited source (Olivares and Uauy 2005) says "The essentiality of fluoride for humans has not been proven unequivocally". It would be misleading to summarize this source by writing "Fluoride is not considered an essential nutrient ...". It would be OK to summarize it as "It is not known whether fluoride is an essential nutrient ...", or something like that. Furthermore, the previous comment doesn't address the point that the example of dietary fiber helps explain to the reader the distinction between a nutrient and an essential nutrient, which is clearly an important distinction to make in this context. No reason has been given for removing this example, which is well supported by a reliable source. Eubulides (talk) 23:41, 12 October 2009 (UTC)
- The goal here is not to repeat the weasel words of one paper, but to summarize the facts at hand and make proper attributions. I would prefer not to explain by analogy, particularly with fiber. If someone wants to more deeply understand the concept they can click on the wiki link to essential nutrient. One sentence of explanation should be able to suffice.
- "Fluoride is not considered an essential nutrient in the sense of being required to sustain life or growth in humans since a diet low in sugar removes the need for fluoride. Scientists have proposed that in modern high sugar diets fluoride should be considered an essential nutrient.[citations]"
- Gregwebs (talk) 04:07, 14 October 2009 (UTC)
- "Fluoride is not considered an essential nutrient" Again, that is not what the cited source says. The cited source (Olivares and Uauy 2005) says that it's not known whether fluoride is an essential nutrient. Sources can certainly be cited saying tht fluoride is an essential nutrient (e.g., Tang et al. 2009, doi:10.1016/j.jhazmat.2009.06.079, Chipponi et al. 1982, PMID 6805293). Other sources say that fluoride is not an essential nutrient, with Jones & Varady 2008 (PMID 18347661) being one of those sources. In an uncertain area like this, the Wikipedia article cannot take sides; the science is genuinely unsettled.
- "Scientists have proposed that" Those are weasel words, no? And they are not in the source.
- "I would prefer not to explain by analogy" Some sort of explanation is needed, because the topic of whether fluoride is an essential nutrient or just a nutrient is directly relevant to the topic of water fluoridation. Several sources say that fluoride is an essential nutrient (see the previous bullet), while several (less-reliable) sources deny that fluoride is a nutrient at all (e.g., "The FDA states specifically that fluoride is not a nutrient"[1]). It's clearly a topic worth covering, so we shouldn't remove all discussion of fluoride as a (inessential) nutrient. The explanation by analogy is a good one, because it conveys to the reader the distinction between an essential and a merely beneficial nutrient far more clearly than a dry definition would. The analogy is not original research, as it's taken straight from the cited source.
- "The goal here is not to repeat the weasel words of one paper, but to summarize the facts at hand and make proper attributions." No weasel words are in this part of the article text now, and the facts are being summarized and properly attributed.
- Eubulides (talk) 06:22, 14 October 2009 (UTC)
- The cited source (Olivares and Uauy 2005) says "The essentiality of fluoride for humans has not been proven unequivocally". It would be misleading to summarize this source by writing "Fluoride is not considered an essential nutrient ...". It would be OK to summarize it as "It is not known whether fluoride is an essential nutrient ...", or something like that. Furthermore, the previous comment doesn't address the point that the example of dietary fiber helps explain to the reader the distinction between a nutrient and an essential nutrient, which is clearly an important distinction to make in this context. No reason has been given for removing this example, which is well supported by a reliable source. Eubulides (talk) 23:41, 12 October 2009 (UTC)
- The text "It has not been proven unequivocally whether fluoride is an essential nutrient" contains quoted weasel words with the goal of making it sound like fluoride is probably an essential nutrient. Keeping this obtuse wording is not required for an accurate summary of the facts at hand. Gregwebs (talk) 19:59, 12 October 2009 (UTC)
- The existing article text in question does not contain speculation, either pro- or anti-fluoride. And the existing text states all the facts given in your proposal. No valid reason has been given to remove the material in question, which is well-supported by reliable sources. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- My suggestion is to avoid copying pro-fluoride speculation and to state the facts: "Fluoride is not considered an essential nutrient in the sense of being required to sustain life or growth in humans. A diet low in sugar removes the need for fluoride." Gregwebs (talk) 15:17, 12 October 2009 (UTC)
- "Fluoride is not considered an essential nutrient in the sense of being required to sustain life or growth in humans- a diet low in sugar removes the need for fluoride. However, in the typical modern high sugar diets fluoride could be considered an essential nutrient."
- Again, it is absolutely ridiculous to state "it has not been unequivocally proven", since we are not (and should not be) quoting the article. If that stays here, we should insert it in every other sentence in the article. If you cannot yield on this point, there is no point in continuing this discussion. Gregwebs (talk) 15:51, 14 October 2009 (UTC)
- This new version removes the "Scientists have reported that" weasel words, which addressed the least important of my objections, but the other objections remain. First, the distinction between essential and beneficial nutrients should be made. Second, the science is not settled as to the essentiality of fluoride as a nutrient, and the text shouldn't say or imply otherwise. Eubulides (talk) 06:50, 15 October 2009 (UTC)
Repeated removal of discussion of nutrient status
Gregwebs (talk · contribs) is repeatedly removing material discussing fluoride as a nutrient (first time, second time). The material is directly supported by high-quality sources, is not controversial among reliable sources, and was carefully reviewed as part of the featured-article process. Please don't simply remove such material without consensus. I suggest that the section be restored to its stable version and that further changes be discussed here. Eubulides (talk) 05:15, 12 October 2009 (UTC)
- I started the discussion of the topic on this page, so it is odd for you accuse me of edit warring. I am all for consensus instead of one person owning this page. Gregwebs (talk) 06:21, 12 October 2009 (UTC)
- You started this thread only after your second revert of well-sourced material, and only after I informed you of the 3RR rule. You are continuing to install obviously-controversial edits into a stable featured article without discussion and without consensus, for example, this edit. These actions are inconsistent with a claim to be all for consensus instead of one person owning the article. I suggest that these changes be reverted and that we discuss them on the talk page. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- I started discussion of the edit in question before I was "informed" of the 3RR rule that I have not violated, and before my first undo. Gregwebs (talk) 14:53, 12 October 2009 (UTC)
- Gregwebs, a reminder to unestablished users to be aware of WP:3RR is not intended as an accusation. Please be aware of 3RR and refrain from reinserting text that does not have consensus; discuss first. SandyGeorgia (Talk)
- For the benefit of editors new to the article, it may be useful to review Talk:Water fluoridation/Archive 3#Essential nutrient, which contains a detailed discussion of the sources and the consensus that was reached, before making changes to the text related to essential nutrients. --RexxS (talk) 17:06, 12 October 2009 (UTC)
NPOV: Missing philosophical argument and citing weakest opponents (straw man fallacy)
Dr. Strangelove's character and the extreme right- and left-wing groups may indeed be opposed to fluoridation, but that movie was clearly intended to ridicule opponents of fluoridation, among other targets. Although some mention is made of medical treatment without informed consent, what's missing is the philosophical debate on whether Government should force medical treatment on an entire population. For example, isn't global overpopulation an even more pressing issue than tooth decay? Ergo (per the ideology that supports fluoridation), put birth-control medications in drinking water globally, until the population is reduced to sustainable levels. Sound silly? Substitute "birth-control medication" for "fluoride" in almost every one of the "pro" arguments. Yes, silly indeed.
Mass forced medication smacks of the comparison we're not allowed to use here (the dreaded H- and N-words, of course). This is the strongest philosophical argument -- the right of individual choice -- but the sources cited seem to focus on the least attractive opponents, namely, a movie intended as slapstick satire, though with a message indeed, and those screaming of Communist plots. The Cold War is over, and fluoride is still here.
I'm not a reliable source to advance this argument, and no, I haven't time to be bold, do the research, source it properly, and edit the article myself. I just came here to look up something else, saw the FA, and... surprised it made it to FA with this notorious example of the Straw man fallacy of logic. Cheers. Unimaginative Username (talk) 05:26, 12 October 2009 (UTC)
- As the Ethics and politics section says, there are important ethical arguments on both sides of the question. The main point made in the above comment seems to be that the phrase "mass medication" is missing from that section. It would be reasonable to add that phrase, supported by a reliable source. However, if you aren't willing to propose specific wording or to do any research, adding a tag to the whole article would seem to be an instance of driveby tagging, a practice that is strongly discouraged on Wikipedia. Eubulides (talk) 05:40, 12 October 2009 (UTC)
- Since Unimaginative Username admits to not having done the research, I have removed the POV tag s/he placed. SandyGeorgia (Talk) 05:42, 12 October 2009 (UTC)
- And also keep edit-conflicting me from responding. I didn't say I haven't done the research in the past, just that I haven't time to collate sources and get it done, not only before FA changes, but before bedtime. A legitimate question has been raised and I invite legitimate opposing comments. Or leave the slanted article up -- this is how you lose formerly active editors like myself, (no threat, statement of past event), impair credibility, and discourage even trying.
- Since Unimaginative Username admits to not having done the research, I have removed the POV tag s/he placed. SandyGeorgia (Talk) 05:42, 12 October 2009 (UTC)
- For an ordinary article, I can understand that policy -- very reasonable. However, this is FA on the Main Page. By the time I were to do all the research necessary, prepare, and edit, it would no longer be FA, and the effect of disputing it, and my reasons for doing so, are lost to all but a fraction of those who will see it while it is Main Page. I think the arguments, which I was enhancing but ran into an edit conflict, speak for themselves, and certainly opposing comments can be added.
- "if you aren't willing to propose specific wording" .... doing so without reliable sources is original research, no? Cheers. Unimaginative Username (talk) 05:52, 12 October 2009 (UTC)
- Edit, after edit conflict: Edit: As more evidence that the article is slanted "pro", consider the picture caption: "Fluoridation does not affect the appearance, taste, or smell of drinking water.[1]" So? Many known poisons are tasteless, odorless, and colorless. This is hardly an argument in favor of fluoridation or its safety, only the answer to a much more trivial argument, whether the water tastes, smells, or looks different. Cf. the fairly recent disclosures by US Environmental Protection Agency finding 50-odd prescription drugs in the drinking water of many US cities -- tranquilizers, anti-depressants, sleeping pills, aforementioned birth control pills, antibiotics, etc, presumably via said drugs being eliminated in urine, and the resultant sewage not being treated sufficiently to eliminate them before being recycled back into tap water. Apparently, none of those affected taste, smell, or color enough for users to gasp, nor to shrink from drinking it. One more example of trivial arguments in favor, the false dichotomy of "public good vs. individual rights" (without individual rights, no public good, nor any other, is possible. You're in a totalitarian slave state, and the possibility of fewer cavities is a ludicrously small compensation), and the presentation of the weakest arguments by the least respected opponents. Unimaginative Username (talk) 05:52, 12 October 2009 (UTC)
- As you mention, the statement "Fluoridation does not affect the appearance, taste, or smell of drinking water." is not an argument in favor of fluoridation or its safety. So I'm puzzled why you are objecting to it. This is an article about water fluoridation in general: it is not particularly an article about whether water fluoridation should or should not be done. When covering the general topic, one of the obvious areas to cover is how fluoridation affects water's taste etc. This is completely independent of whether fluoridation is safe. The lead sentence of Carbon monoxide says that CO is "colorless, odorless, and tasteless", but that doesn't mean we should slap a POV tag on that article. Eubulides (talk) 06:27, 12 October 2009 (UTC)
wow isn't it ironic that this article doesn't mention how hitler, stalin, AND mussolini all fluoridated their population's water to pacify them? lol isn't it ironic dont u think, wikipedia is neutral (LMFAO) —Preceding unsigned comment added by 75.1.48.21 (talk) 06:09, 12 October 2009 (UTC)
- The Ethics and politics section does cover the theory that water fluoridation was designed to make people submissive to those in power. No reliable sources support the claim that Hitler, Stalin, and Mussolini all fluoridated their population's water to pacify them, but the topic is notable enough to be briefly summarized in that section. Eubulides (talk) 06:27, 12 October 2009 (UTC)
I agree that NPOV is missing from this article. Take a look at the cited study "Community water fluoridation and caries prevention: a critical review" doi:10.1007/s00784-007-0111-6. PMID 17333303. It is very harsh on water fluoridation, and yet it seems to be used only to point out that water fluoridation is safe. Given all the previous discussions about problems with this article and the doppelganger opposition article, it was very suprising to see this article on the front page of Wikipedia. Gregwebs (talk) 06:43, 12 October 2009 (UTC)
- The previous comment is completely incorrect. The study in question, Pizzo et al. 2007 (PMID 17333303), is cited ten times in the article, to support many claims that are critical of water fluoridation, including questions of violations of ethical and legal rules, issues of informed consent, legal issues, the claim that water fluoridation may not be needed at all, the claim that toothpaste is a better way to prevent cavities, the claim that the main reason for the decline in tooth decay is toothpaste, the claim that there is only limited evidence that fluoridation reduces oral health inequalities, the claim that most countries of Europe have experienced decline in dental caries without using water fluoridation, and the claim that all fluoridation methods (including toothpaste) work about the same way. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- Ok, good point, but the problem still remains that much of the point of that review has been put into the alternatives section, instead of the effectiveness section, and that it is being countered by weak evidence about inequalities in the U.S. Overall this article maintains a dispassionate tone and abides by the rules Wikipedia has layed out, but it has managed to make fluoridation appear to be a godsend, when this, many other sources, and the history of Europe have made an extremely strong case that it is unneeded in the modern world. —Preceding unsigned comment added by Gregwebs (talk • contribs) 15:36, 12 October 2009 (UTC)
- From the point of view of someone who supports fluoridation, the article gives a too-heavy coverage to opponents. From the point of view of someone who opposes it, the article gives a too-heavy coverage to proponents. In no sense does the article make fluoridation appear to be a "godsend". It extensively covers the evidence from Europe that fluoridation is not needed in industrialized countries, and mentions this in the lead. It also mentions, both in the lead and in the body, that the evidence in favor of fluoridation is not of high quality, and that the practice is controversial. This is not to say that the article is perfect (far from it!), and specific suggestions for improvement are welcome, but please bear in mind that the article is supposed reflect what reliable sources say about fluoridation, roughly in proportion to the weight that they say it, regardless of one's own personal opinion about fluoridation. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- Ok, good point, but the problem still remains that much of the point of that review has been put into the alternatives section, instead of the effectiveness section, and that it is being countered by weak evidence about inequalities in the U.S. Overall this article maintains a dispassionate tone and abides by the rules Wikipedia has layed out, but it has managed to make fluoridation appear to be a godsend, when this, many other sources, and the history of Europe have made an extremely strong case that it is unneeded in the modern world. —Preceding unsigned comment added by Gregwebs (talk • contribs) 15:36, 12 October 2009 (UTC)
Removal of CDC material from body of article
This edit removed from the body the claim "Water fluoridation has been listed as one of the ten great public health achievements of the 20th century in the U.S." (leaving it only in the lead), and removed from the article entirely the point that this was "alongside vaccination, family planning, recognition of the dangers of smoking, and other achievements." The first deletion violates WP:LEAD, which says that the lead should summarize the body: it's not right for the lead to make a claim that is not also in the body. The second deletion removes valuable context, in that it gives the reader a better feeling for how important the CDC thinks water fluoridation is. Regardless of whether one agrees with the CDC, this context should be presented. I suggest that the edit be reverted. Perhaps the material should be moved or reworded, but it shouldn't be deleted entirely.
Also, I'd like to suggest that in the future, possibly-controversial edits like this should be discussed first on the talk page, before being installed. Eubulides (talk) 07:16, 12 October 2009 (UTC)
- I have reverted this change. This text has been thoroughly discussed and reviewed. There's WP:BOLD and there's taking a scythe to an article on the main page. Controversial articles should be edited delicately and after discussion reaches consensus. The article will still be here tomorrow. Colin°Talk 07:48, 12 October 2009 (UTC)
Sorry, I didn't think this edit could possibly be controversial. Making someone's top-ten list has nothing do with evidence basis of effectiveness. Please move this text to an appropriate section (history?) of the article. Gregwebs (talk) 14:10, 12 October 2009 (UTC)
- That is a reasonable proposal. I suggest that we move the top-ten material to the 2nd paragraph of Ethics and politics. (But not right now, as the article is being munged too much while it's on the main page, and anyway other editors may want to chime in here first.) Eubulides (talk) 19:42, 12 October 2009 (UTC)
- Even when its about health and from the CDC? 173.22.123.35 (talk) 22:04, 12 October 2009 (UTC)
- It is partly a health statement, and partly a political statement. There are valid arguments for putting it in Evidence basis, and valid arguments for putting it in Ethics and politics. I would be interested to hear what other editors think on the subject. Eubulides (talk) 23:41, 12 October 2009 (UTC)
Satire
This article needs a picture from Dr Strangelove. lol 58.167.41.154 (talk) 09:00, 12 October 2009 (UTC)
Article praise
I like this article, it's quite a nice one to be featured. One question, is a see also section with one point really worth it? Either expand it (perhaps with an article on water contamination rates per country, or something like that, or incorporate the existing link into the prose and remove the section? Good work. SGGH ping! 11:51, 12 October 2009 (UTC)
- Good catch, thanks! SandyGeorgia (Talk) 14:09, 12 October 2009 (UTC)
Missing Opposition?
I used to be all for Fluoridation, but much of the opposition, starting as early as the '50's, was evidence of lowered test scores. This is not addressed; it is only "glazed over" by: "lack of evidence of harmful effects". There IS evidence. I ask this point be included in "Opposition".68.231.189.108 (talk) 12:59, 12 October 2009 (UTC)
- Agree. Such prominent opponents of water fluoridation have included Dr. Bronner, who was arrested for his activities to protest water pluoridation in the 1950s. Drinking water sources have been a convenient source for the disposal of fluoride waste under the reasoning of, "fluoride prevents tooth decay." Meanwhile many brands of natural toothpaste now boast that they do not contain fluoride because of health concerns. This article, as it stands today as Wikipedia's featured article, reads as propaganda for water fluoridation, not presenting a neutral view of the subject as is befitting of Wikipedia's standards. —Morganfitzp (talk) 13:23, 12 October 2009 (UTC)
- These arguments should be based on reliable sources that are peer-reviewed and recent. Opposition is well covered, and included in the lead. SandyGeorgia (Talk) 13:45, 12 October 2009 (UTC)
- I'd object to putting pluride in water; is it a form of plutonium? Sounds nasty. In order to avoid accusations of being off topic, I agree with Sandy, and we have a different article for these sorts of things too (which also requires RS). Verbal chat 14:01, 12 October 2009 (UTC)
- These arguments should be based on reliable sources that are peer-reviewed and recent. Opposition is well covered, and included in the lead. SandyGeorgia (Talk) 13:45, 12 October 2009 (UTC)
- There is no reliable evidence that water fluoridation lowers test scores or IQ, or that it causes Down's syndrome, senile dementia, goiter, etc. The article is relying on recent reliable reviews of fluoridation (some pro-fluoridation, and some anti-); none of them say that there is any evidence along these lines. The only clear adverse effect is dental fluorosis, and this is covered at some length in the Safety section and mentioned in the lead. Eubulides (talk) 19:42, 12 October 2009 (UTC)
I don't have any axe to grind on this topic but I agree that the opposition argument is not well covered at all and this article doesn't present a balanced view. If I can quote from the opening paragraphs of article used for reference no. 79:
For eons now, liberals have teased conservatives about one thing (well, many things, but I'm thinking of one in particular): the fluoridation of water fluoridation of water
Addition of fluoride compounds to water (see fluorine) at one part per million to reduce dental caries (cavities). This practice is based on the lower rates of caries seen in areas with moderate natural fluoridation of water and on studies ..... Click the link for more information.. "Oh, you work at National Review? What do you do, write editorials denouncing the fluoridation fluoridation (flr'ĭdā`shən), process of adding a fluoride to the water supply of a community to preserve the teeth of the inhabitants. of the water supply?" Ha, ha, ha. (Actually, we spend our time advocating separate lunch counters for Negroes.) In many quarters, "fluoridation of water" is a code word for right-wing kookery.
Well, imagine my surprise -- and delight -- when I was talking recently with a dentist friend of mine and the subject of water fluoridation came up: "We still have to fight on that, all over the country," he said. "What," I said, "you mean the Birchers are still at it?" "Oh, no," he replied. "It's the Left. The opposition comes from the environmentalist environmentalist
a person with an interest and knowledge about the interaction of humans and animals with the environment. , earthy-crunchy, sandal-wearing Left."
Well, well, well. Who's laughin' now, baby?
Is this what passes for a reliable source that is peer-reviewed and recent?
Then there is a passage in the wikipedia article that says:
Media reporters are often poorly equipped to explain the scientific issues, and are motivated to present controversy regardless of the underlying scientific merits. Internet websites, which are increasingly used by the public for health information, contain a wide range of material about fluoridation ranging from factual to fraudulent, with a disproportionate percentage opposed to fluoridation. Antifluoridationist literature links fluoride exposure to a wide variety of effects, including AIDS, allergy, Alzheimer's, arthritis, cancer, and low IQ, along with diseases of the gastrointestinal tract, kidney, pineal gland, and thyroid.
I think it would be much better to preface this with something like " a critical examination of antifluoridationist literature published in 2007 argued that" rather than present these arguments as a statement of facts. Richerman (talk) 15:10, 12 October 2009 (UTC)
- The first source mentioned above, Nordlinger 2003, is cited only on the politics of water fluoridation, not about its medical or technical aspects. I agree that it would be better to cite a peer-reviewed source on the topic, preferably something more recent, but in the meantime this source is adequate to support the entirely non-controversial claim that opposition to fluoridation has come from right wing groups such as the John Birch Society, and more recently from left-wing groups such as some Green parties.
- The second source mentioned above, Armfield 2007 (PMID 18067684), is a reliable peer-reviewed source, and none of the article text that it supports is controversial among reliable sources. There is no need for in-text attribution for claims that are not controversial among reliable sources.
- Eubulides (talk) 19:42, 12 October 2009 (UTC)
- The "balance" is given by WP:UNDUE and WP:FRINGE covers the minority view that fluoride in water is dangerous. Verbal chat 15:14, 12 October 2009 (UTC)
- The statement of supporting arguments as facts (when all opposing must be qualified) may be the main problem with this article. This may be a violation of WP:ATTRIBUTEPOV Gregwebs (talk) 16:31, 12 October 2009 (UTC)
- Generally speaking, the article uses in-text attribution only when discussing topics that are disputed among reliable sources. For example, reliable sources do not agree that fluoridation is one of the top-ten public health achievements of the 20th century, so it's appropriate for an in-text attribution of this opinion to the CDC. However, where reliable sources agree on a topic, it would be misleading to use in-text attribution for that topic, as it would incorrectly suggest to the reader that the topic is controversial among reliable sources. So, for example, reliable sources agree that the goal of fluoridation is to prevent tooth decay, so it would be misleading for the Goal section to begin with something like "The Centers for Disease Control says that water fluoridation's goal is to prevent tooth decay", as this would suggest to the reader that other reliable sources say that fluoridation's goal is actually something else; here, it more accurate simply to give a footnoted attribution in the usual way. This style is standard in Wikipedia, and you'll see it used in many other high-quality articles that discuss controversial subjects. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- Of course I am not arguing against the sample you gave. I take issue mostly with statements like "Fluoride has contributed to the dental health of children and adults worldwide." in the evidence section. Besides lacking attribution to POV, it is also vague to the point that it is simply promotional. Gregwebs (talk) 20:18, 12 October 2009 (UTC)
- But there is no dispute among reliable sources that fluoride has contributed to the dental health of children and adults worldwide. Fluoride does have disadvantages, which are also discussed. It is not POV or promotional to list its advantages as well as its disadvantages. Eubulides (talk) 23:41, 12 October 2009 (UTC)
- Of course I am not arguing against the sample you gave. I take issue mostly with statements like "Fluoride has contributed to the dental health of children and adults worldwide." in the evidence section. Besides lacking attribution to POV, it is also vague to the point that it is simply promotional. Gregwebs (talk) 20:18, 12 October 2009 (UTC)
- Generally speaking, the article uses in-text attribution only when discussing topics that are disputed among reliable sources. For example, reliable sources do not agree that fluoridation is one of the top-ten public health achievements of the 20th century, so it's appropriate for an in-text attribution of this opinion to the CDC. However, where reliable sources agree on a topic, it would be misleading to use in-text attribution for that topic, as it would incorrectly suggest to the reader that the topic is controversial among reliable sources. So, for example, reliable sources agree that the goal of fluoridation is to prevent tooth decay, so it would be misleading for the Goal section to begin with something like "The Centers for Disease Control says that water fluoridation's goal is to prevent tooth decay", as this would suggest to the reader that other reliable sources say that fluoridation's goal is actually something else; here, it more accurate simply to give a footnoted attribution in the usual way. This style is standard in Wikipedia, and you'll see it used in many other high-quality articles that discuss controversial subjects. Eubulides (talk) 19:42, 12 October 2009 (UTC)
I'm not asking that you give them more weight - just that they aren't dismissed out of hand. Although the reference I mentioned is pretty poor for a citation as it's not peer reviewed as far as I can see, the writer does make some valid points. To quote:
Still, the mainstreamers can be awfully high-handed when it comes to the anti-fluoridationists. Paul Connett complains, "Promoters of fluoridation refuse to recognize that there is any scientific debate on this issue." That's largely true. Connett points out that a leading fluoridation proponent has said, "Debates give the illusion that a scientific controversy exists when no credible people support the fluorophobics' view." That is patently untrue. Many dentists -- unorthodox, to be sure -- oppose fluoridation, and the "fluorophobics" can boast some heavy-hitters, like Arvid Carlsson, winner of the 2000 Nobel prize Nobel Prize, award given for outstanding achievement in physics, chemistry, physiology or medicine, peace, or literature. The awards were established by the will of Alfred Nobel, who left a fund to provide annual prizes in the five areas listed above. ..... Click the link for more information. in medicine. And yet many of the mainstreamers persist in treating every anti-fluoridationist like a street-corner quack. Indeed, there are anti-anti-fluoridationist whacks at QuackWatch.org. This site contains an article -- generally informative and persuasive -- that says, "The anti-fluoridationists' basic technique is the big lie. Made infamous by Hitler, it is simple to use, yet surprisingly effective." This is perhaps not the best way to win an argument, especially with serious-minded people. The anti-fluoridationists complain that the mainstreamers are afraid to debate them, relying on dogma, tradition, and prejudice instead of scientific fact.
Richerman (talk) 15:28, 12 October 2009 (UTC)
- The previous comment is a reasonable request. However, Water fluoridation does not dismiss antifluoridationist arguments out of hand. It describes them prominently, and mentions them in the lead, giving them the approximate weight that reliable sources do. The article should not say or imply that there is no scientific debate on this issue, and it should not say or imply that all antifluoridationist arguments are street-corner quackery. If there's any specific place in Water fluoridation where it mistakenly dismisses antifluoridationist arguments, please let us know, ideally with suggestions for improved wording. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- First of all I think that labelling the The John Birch Society and Greenpeace as right wing and left wing, although probably somthing many would agree with, is POV and sounds rather dismissive of their views. Secondly I think the sentence I mentioned earlier needs some qualification and would suggest that it should read "Proponents argue that media reporters are often poorly equipped to explain the scientific issues......etc." When I say about dismissing the arguments out of hand, maybe that's a bit strong, but what I mean is coming down too heavily on the side of proponents. So saying "Opposition campaigns involve newspaper articles, talk radio, and public forums. Media reporters are often poorly equipped to explain the scientific issues..." Is implying that the proponents are right and the "antis" are obviously wrong, and that's not neutral enough. Richerman (talk) 10:02, 13 October 2009 (UTC)
- My sense on reading this report is that it approaches over-legitimizing the opposition to the fluoridation of water. The practical problem arises as to when and how it is appropriate to be dismissive. The opposition is diverse organizationally and highly vocal, but the opposition is represented by no large scientific organization on the scale and with the legitimacy of the AMA, WHO, CDC, National Academy, Royal Society. Instead, the opposition is more commonly represented by single issue books or organizations such as the Fluoride Action Network. A related practical problem is that so much energy is focused on subtly rebalancing this article, yet parallel care is not diected at the Wiki articles that have been created to cater to the opposition. These articles lose their legitimacy because they come across as less balanced and in some cases almost strident. In the perfect world the POV aspect would be discussed in the content of the collection of articles on fluoridation. But the topic is too hot emotionally to handle cooly.--Smokefoot (talk) 12:56, 13 October 2009 (UTC)
- First of all I think that labelling the The John Birch Society and Greenpeace as right wing and left wing, although probably somthing many would agree with, is POV and sounds rather dismissive of their views. Secondly I think the sentence I mentioned earlier needs some qualification and would suggest that it should read "Proponents argue that media reporters are often poorly equipped to explain the scientific issues......etc." When I say about dismissing the arguments out of hand, maybe that's a bit strong, but what I mean is coming down too heavily on the side of proponents. So saying "Opposition campaigns involve newspaper articles, talk radio, and public forums. Media reporters are often poorly equipped to explain the scientific issues..." Is implying that the proponents are right and the "antis" are obviously wrong, and that's not neutral enough. Richerman (talk) 10:02, 13 October 2009 (UTC)
- The article says that Organized political opposition has come from right-wing groups ... and more recently from left-wing groups ... - both John Birch Society and Greenpeace are given merely as examples. The point is, surely, that both sides of the political spectrum have provided organised political opposition? (rather than "these groups can be dismissed because they are labelled X or Y".) Also, I cannot see how you draw your implication on the second point. Opposition campaigns involve newspaper articles, talk radio, and public forums. Media reporters are often poorly equipped to explain the scientific issues, and are motivated to present controversy regardless of the underlying scientific merits implies nothing more than the vehicle chosen for the campaign is not good at explaining the science, but instead will convey that campaign for other reasons. It makes no comment on the underlying rightness of the opposition's campaign. That's as neutral as anyone could reasonably expect. --RexxS (talk) 13:13, 13 October 2009 (UTC)
- In answer to the point above about other articles on this subject, I'm interested in this one because it's a featured article that was on the front page and as such is supposed to be the best that wikipedia can produce and should stand on its own merits. I presume the others you're talking about are not featured articles for the reasons you've mentioned. As I said I have no strong opinions on this subject either way and was merely acting as devil's advocate trying to see how someone from the "anti" side would see the way the arguments were presented. I notice no-one has seen fit to comment on what I said about the quality of reference 79. However, I know when I'm flogging a dead horse so, if you're happy with the article, by all means leave it as it is. Richerman (talk) 14:34, 13 October 2009 (UTC)
Rephrase of last para in lead
This edit ("edited last paragraph of lead for style and accuracy") introduced a POV style where the previous text was neutral. The "but" and the "although" set sentences in opposition to each other where none is required. Also the change from "It is controversial..." to "Treatment of the public water supply is controversial..." is incorrect. The previous "it" referred to water fluoridation whereas treatment of the water supply (in general, for example to clean it and add chlorine) is not a controversial subject.
The other changes made the prose wordier and added unnecessary detail for the lead.
The change to the last sentence paragraph I'm not sure about. It previously said "it is now used by 5.7% of people worldwide." but now says "some 5.7% of people worldwide now receive water containing fluoride to around 1 mg/L". The latter includes naturally fluoridated water. Which is correct?
I've reversed the edit for now. Colin°Talk 16:05, 12 October 2009 (UTC)
- Thanks. I agree with the reversal. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- The reason why I changed the wording was that the construction of the paragraph was not good with short sentences and too many "its". I accept that the bit about treatment of water was not the best wording but I was trying to make it less repetitive. The bit in last sentence "5.7% of people worldwide now receive water containing fluoride to around 1 mg/L" is what the reference says - it's on line you can check it yourself. The bit about flouridation preventing cavities is complete nonsense - it reduces the incidence of them. I changed cavities to dental caries as that's the correct term and it's what they are called in the reference. By all means change what you don't like but don't throw out the baby with the bathwater. Richerman (talk) 19:57, 12 October 2009 (UTC)
- You are right about the 5.7 bit, sorry about that. The prose might not have been perfect but the changes were worse as they introduced POV. I've removed the "now" as it isn't in the source and the word best avoided on WP. The "preventing cavities" isn't nonsense -- only if you take it as 100% effective as preventing cavities. Vaccines and washing your hands both prevent disease -- there's no "may prevent" about it. The point is that saying "may help prevent" introduces doubt as to whether it has any preventative action, which isn't the case. Colin°Talk 22:23, 12 October 2009 (UTC)
- Colin's right about "may prevent" being wrong; the first paragraph of the source talks about fluoridation being a "method of caries prevention", with no "may" in sight. The phrase "reduces the incidence of dental caries" is too technical for the lead; as per WP:LEAD and WP:MEDMOS the lead should prefer widely-accessible language to technically-correct but hard-to-understand language. There's no reason to wikilink to dental caries here, since the lead has already wikilinked to tooth decay, an easier-to-understand redirect to dental caries. It's better to be consistent in using simpler terminology in the lead, so I changed "reduces the incidence of dental caries" back to the simpler "prevents tooth decay". The "now" was in the text to provide linkage from the 1st half of the sentence, which talks about events in the 1950s; that same edit inserted "as of 2004" to restore this linkage and to reflect the date of the estimate. Eubulides (talk) 06:33, 13 October 2009 (UTC)
- You are right about the 5.7 bit, sorry about that. The prose might not have been perfect but the changes were worse as they introduced POV. I've removed the "now" as it isn't in the source and the word best avoided on WP. The "preventing cavities" isn't nonsense -- only if you take it as 100% effective as preventing cavities. Vaccines and washing your hands both prevent disease -- there's no "may prevent" about it. The point is that saying "may help prevent" introduces doubt as to whether it has any preventative action, which isn't the case. Colin°Talk 22:23, 12 October 2009 (UTC)
- The reason why I changed the wording was that the construction of the paragraph was not good with short sentences and too many "its". I accept that the bit about treatment of water was not the best wording but I was trying to make it less repetitive. The bit in last sentence "5.7% of people worldwide now receive water containing fluoride to around 1 mg/L" is what the reference says - it's on line you can check it yourself. The bit about flouridation preventing cavities is complete nonsense - it reduces the incidence of them. I changed cavities to dental caries as that's the correct term and it's what they are called in the reference. By all means change what you don't like but don't throw out the baby with the bathwater. Richerman (talk) 19:57, 12 October 2009 (UTC)
5.7% bit
The source for the 5.7% is an article in the BMJ. Good. It says "Worldwide, about 5.7% of people receive water containing fluoride to around 1 mg/l." This is slightly different to our current lead text which says "about 5.7% of people worldwide receive water fluoridated to around 1mg/L." It is ambiguous whether "fluoridated" implies human intervention but on balance it probably would read that way in an article on the human intervention. So perhaps this should be fixed. However, the BMJ's source for this is National Public Health Service for Wales Briefing paper on fluoridation and the implications of the Water Act 2003. This contains the text "Worldwide over 360 million people drink fluoridated water -- either naturally occurring or adjusted to the optimum level of fluoride to reduce tooth decay." It doesn't mention 5.7 and it doesn't include 1mg/l in that sentence (though earlier it does say the optimum level is 1mg/l). The sentence doesn't indicate the level of fluoride in the naturally-occurring water. I wonder if the BMJ is not only using a sub-optimal source but is also reading too much into the source in order to do its maths. The National Public Health Service for Wales must have got its data from somewhere better. Can we find it? Colin°Talk 22:45, 12 October 2009 (UTC)
- I remember following the exact same reference trail that you did, and ended up with "moderate fluoridation prevents cavities,[1] and it is now used by 5.7% of people worldwide." being the best summary of the original source (while also agreeing with the cited source). I'll see if I can reconstruct that when I have a bit more time. Eubulides (talk) 23:41, 12 October 2009 (UTC)
- The Wales briefing paper got its data from an earlier edition of "One in a million", whose latest (2004) edition (PDF) estimates about 400 million people worldwide drink fluoridated water; this includes about 50 million who drink water that is naturally fluoridated to a value around optimal. (These figures are rounded, by the source, from more-precise figures.) Given that we now have later figures, we should consistently cite the newer figures instead of the older ones, and I installed an edit to do that. Eubulides (talk) 06:33, 13 October 2009 (UTC)
Ethics and Politics section & note 81
A passage immediately after note 80 and before note 81 reads:
- Many people do not know that fluoridation is meant to prevent tooth decay, or that natural or bottled water can contain fluoride
Is the source for note 81 being cited for this claim, or only for the sentence following, the one beginning, "A 2009 survey of Australians..."? Only an abstract of the source article is available to non-subscribers, so perhaps someone with access can confirm that the source makes a claim about the prevalence of knowledge about the purpose or fluoridation or the presence of fluoride in bottled water. If it doesn't, this claim is unsourced and ought to be removed. --Rrburke(talk) 16:37, 12 October 2009 (UTC)
- Thank you for catching that error. The source for that claim is actually Griffin et al. 2008 (PMID 18333872), which says (p. 100) "However, many had a poor understanding of the benefits and costs associated with fluoridation. They seemed unaware that water could naturally contain fluoride or that some bottled mineral waters actually have a very high fluoride content. Studies in the USA and South Africa have shown that many people did not know water fluoridation was intended to prevent tooth decay, although that knowledge was better in higher educated groups and among older people." The claim was properly sourced when it was originally inserted, but became separated from its source in a later edit. I fixed the problem by adding a named ref to the source. Eubulides (talk) 19:42, 12 October 2009 (UTC)
- But since it is apparent that there is indeed disagreement as to whether there are or are not benefits associated with the use of fluoride and fluoridation, isn't this a rather poor source? The statement "many had a poor understanding of the benefits . . ." actually means, "a lot of people disagreed with this estemmed group of scientists and social engineers." If this had been an anti-fluoride source, wouldn't it have read, "many seemed to naturally sense the harmful affects of forced fluoridation"? The poor quality of the source is further indicated by the use of "very high" as a precise measurement of some approximation. It doesn't matter what side you pick, but the sources ought to be good sources. 67.172.153.122 (talk) 20:24, 12 October 2009 (UTC)
- There's nothing wrong with the sentence or the use of the source to support it. It provides support for people being unaware that fluoridation is intended to prevent caries, and that people are unaware that bottled water may contain fluoride. Fences&Windows 21:44, 12 October 2009 (UTC)
- I agre with Fences and windows here. Also, the word "benefits" does not appear in the Water fluoridation passage in question, so I don't see why it's important to focus on that word in this thread. Eubulides (talk) 23:41, 12 October 2009 (UTC)
- There's nothing wrong with the sentence or the use of the source to support it. It provides support for people being unaware that fluoridation is intended to prevent caries, and that people are unaware that bottled water may contain fluoride. Fences&Windows 21:44, 12 October 2009 (UTC)
- But since it is apparent that there is indeed disagreement as to whether there are or are not benefits associated with the use of fluoride and fluoridation, isn't this a rather poor source? The statement "many had a poor understanding of the benefits . . ." actually means, "a lot of people disagreed with this estemmed group of scientists and social engineers." If this had been an anti-fluoride source, wouldn't it have read, "many seemed to naturally sense the harmful affects of forced fluoridation"? The poor quality of the source is further indicated by the use of "very high" as a precise measurement of some approximation. It doesn't matter what side you pick, but the sources ought to be good sources. 67.172.153.122 (talk) 20:24, 12 October 2009 (UTC)
What?
I edited this page, saying that flouride was different than flourine. Later, the administrator deleted it and sent me a message saying I needed to cite the source. I'm sorry, but I think that pretty common knowledge. Sdeas (talk) 23:22, 12 October 2009 (UTC)Sdeas
- Indeed, it is such common knowledge that it doesn't need to be stated in an article about Water fluoridation, and that's the reason why your edit was removed (three times). Thank you for taking the time to discuss this here, but unless you can show that there exists some confusion between fluoride and fluorine (using reliable sources), then the statement really is unnecessary in this featured article. Hope that helps --RexxS (talk) 23:33, 12 October 2009 (UTC)
- The change did not say that fluoride is different from fluorine; it said that fluoride is not to be confused with fluorine. It's not clear that such a statement is important to be in the lead. Is there a reliable source saying that such confusion is common and is notable in the context of water fluoridation? If not, I suggest moving the point to Fluoride, where it's more relevant. Eubulides (talk) 23:41, 12 October 2009 (UTC)
Western Europe Comparison
A fairly large number of western european countries do not have any form of water flouridation and have the same, if not lower, levels of dental problems. - Dr. Joseph Diamond, Dimensio —Preceding unsigned comment added by Dimensio (talk • contribs) 23:11, 12 October 2009 (UTC)
- The article says Most countries in Europe have experienced substantial declines in cavities without the use of water fluoridation. - citing
- Pizzo G, Piscopo MR, Pizzo I, Giuliana G (2007). "Community water fluoridation and caries prevention: a critical review". Clin Oral Investig. 11 (3): 189–93. doi:10.1007/s00784-007-0111-6. PMID 17333303.
{{cite journal}}
: CS1 maint: multiple names: authors list (link)
- Pizzo G, Piscopo MR, Pizzo I, Giuliana G (2007). "Community water fluoridation and caries prevention: a critical review". Clin Oral Investig. 11 (3): 189–93. doi:10.1007/s00784-007-0111-6. PMID 17333303.
- Are you suggesting a different wording, and if so, what is your source? --RexxS (talk) 23:26, 12 October 2009 (UTC)
- The comment "A fairly large number of western european countries do not have any form of water flouridation and have the same, if not lower, levels of dental problems." is surely well intentioned, but it glosses over a complex aspect. There are many countries in western europe and thus many modalities have come and gone in these countries, in some cases with variations province by province. As explained in the article, among the many modalities are salt fluoridation and milk fluoridation. Concurrently, fluoridated toothpaste became widely used as did the use of topical fluoride gels during dental check-ups. So Europe and other parts of the 1st world have experienced a broad multifaceted exposure to fluoridation. Would-be correlations of dental caries rates require an assessment of the total fluoride exposure. With many fluoridation modalities in place, the fluoridation of public waters would have less impact on dental health.--Smokefoot (talk) 02:45, 13 October 2009 (UTC)
Linking common units
Any thoughts on whether the links in milligrams per liter serve any purpose at all? (The second one crept in yesterday.) I know that WP:LINK#What generally should not be linked qualifies its recommendation not to link common units with a suggestion to provide conversions, but here there isn't an appropriate conversion - unless somewhere in the backwoods they're measuring fluoridation levels as 0.0001 ounces per gallon? Would anyone unfamiliar with these units gain a better understanding of the concentration of fluoride by reading where those links take them? I seriously doubt it, and would strongly suggest removing those links in this case. --RexxS (talk) 12:39, 13 October 2009 (UTC)
Remove improperly cited vague sentence leading the Effectiveness section
"Fluoride has contributed to the dental health of children and adults worldwide."
This sentence leading the Effectiveness section is vague to the point of being useless and just looks like fluoride promotion. The statement is not event supported by its citation. —Preceding unsigned comment added by Gregwebs (talk • contribs) 02:58, 14 October 2009 (UTC)
- It looks like a straightforward statement of fact to me, particularly as the introductory sentence to a section on "Effectiveness". The source cited states:
Perhaps it would be helpful if you could indicate which part(s) of the sentence you have problems with?Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries.
- Fluoride's contribution to dental health?
- The contribution to children's dental health?
- The contribution to adults' dental health?
- The contribution to dental health in many countries?
- I think that when you define your objections, you'll see that the sources in the article actually do support the sentence. --RexxS (talk) 03:34, 14 October 2009 (UTC)
- Objections: WP:WEASEL, WP:NPOV, mixes concepts
- The statement is about "Fluoride" instead of "Water fluoridation"
- The vagueness of "worldwide"
- The vagueness of "has contributed"
- The interjection of the word "children"
- The statement being made factual instead of attributed
- This section is supposed to be about the effectiveness of water fluoridation, not about how wonderful fluoride is for our children. —Preceding unsigned comment added by Gregwebs (talk • contribs) 03:58, 14 October 2009 (UTC)
- Objections: WP:WEASEL, WP:NPOV, mixes concepts
- The section does need a lead; we can't simply remove the sentence and leave a gap. It would make sense to make the sentence more specific about water fluoridation. How about replacing the lead with "Water fluoridation reduces tooth decay in children and adults."? That's short and sweet and summarizes the section nicely. The cited source makes a clear distinction between children and adults, so our text should too. The sentence should be attributed in the usual way with a footnote, not with in-text attribution, because in-text attribution would incorrectly convey to the reader the impression that the claim is controversial among reliable sources. Eubulides (talk) 06:22, 14 October 2009 (UTC)
- Indeed, this lead sentence would be more useful if it specified "water fluoridation" vs just "fluoride." Other sentences in the same paragraph also could be improved as indicated by my {inserts}: "Moderate-quality research {sounds like an attempt to placate a complaining group}} exists as to water fluoridation's effectiveness {for what?, dental health one assumes, isn't that the point of the whole article and the reason that the US CDC lists fluoridation of water as a top ten advance?}"--Smokefoot (talk) 12:54, 14 October 2009 (UTC)
- The suggested intro is better, but still not specific enough. "Water fluoridation reduces tooth decay in those whose teeth do not regularly come in contact with fluoride." Gregwebs (talk) 15:31, 14 October 2009 (UTC)
- That's circular. With water fluoridation their teeth will regularly come in contact with fluoride. Colin°Talk 15:37, 14 October 2009 (UTC)
- "... teeth do not *otherwise* regularly ...". Reliable sources used in this article show that in Europe, where there is no water fluoridation, they have reduced tooth decay. These sources attribute it in large part to other sources of fluoride, such as fluoridated toothpaste. Water Fluoridation would have been of little benefit to them, just as it is of little benefit to anyone who already has adequate fluoride exposure. —Preceding unsigned comment added by Gregwebs (talk • contribs) 16:00, 14 October 2009 (UTC)
- The claim "Water fluoridation reduces tooth decay in those whose teeth do not otherwise regularly come in contact with fluoride." is not directly supported by the cited source, so we can't use that wording. Furthermore, the wording clearly implies that fluoridation does not reduce tooth decay in those who brush with fluoride toothpaste regularly, an implication that is incorrect. Let's leave the topic sentence short, sweet, and a summary of the section, rather than introduce unsupported (and incorrect) editorial opinion. Eubulides (talk) 06:50, 15 October 2009 (UTC)
- "... teeth do not *otherwise* regularly ...". Reliable sources used in this article show that in Europe, where there is no water fluoridation, they have reduced tooth decay. These sources attribute it in large part to other sources of fluoride, such as fluoridated toothpaste. Water Fluoridation would have been of little benefit to them, just as it is of little benefit to anyone who already has adequate fluoride exposure. —Preceding unsigned comment added by Gregwebs (talk • contribs) 16:00, 14 October 2009 (UTC)
- That's circular. With water fluoridation their teeth will regularly come in contact with fluoride. Colin°Talk 15:37, 14 October 2009 (UTC)
- The section does need a lead; we can't simply remove the sentence and leave a gap. It would make sense to make the sentence more specific about water fluoridation. How about replacing the lead with "Water fluoridation reduces tooth decay in children and adults."? That's short and sweet and summarizes the section nicely. The cited source makes a clear distinction between children and adults, so our text should too. The sentence should be attributed in the usual way with a footnote, not with in-text attribution, because in-text attribution would incorrectly convey to the reader the impression that the claim is controversial among reliable sources. Eubulides (talk) 06:22, 14 October 2009 (UTC)
No mention of blood concentration of fluoride?
There is no mention of fluoride levels found in blood. This needs to be resolved. There is also evidence suggesting that animals will suffer kidney and liver function damage due to water fluoridation. This is important information for this article: http://www.ncbi.nlm.nih.gov/pubmed/16834990
Highest disease cost uncited.
The reference to "and costing society more to treat than any other disease." is unsupported by the reference given. Forbes calls "Heart Disease" the highest: http://www.forbes.com/2005/04/14/cx_mh_0414healthcosts.html though I don't know who they are citing.
This claim needs to be investigated before it goes on the article. —Preceding unsigned comment added by Bitcloud1 (talk • contribs) 12:41, 15 October 2009 (UTC)
- The cited source says "Dental diseases, particularly dental caries, are the most expensive part of the body to treat. Caries is indeed the most expensive human disease in terms of direct costs. For example, the direct costs of caries treatment in Germany was 20.2 billion, CVD 15.4 billion DM, diabetes 2.3 billion DM.4. In West Germany, the cost of dental care was 10.3% of the health budget in 1994." (my emphasis) I suspect Forbes either forgot that caries was a disease, or asked a bunch of doctors and forgot to ask the dentists too. Colin°Talk 12:52, 15 October 2009 (UTC)
Thanks for the citation. A little extra research yeilds this from WHO: "Moreover, traditional treatment of oral disease is extremely costly, the fourth most expensive disease to treat in most industrialized countries." http://www.who.int/oral_health/disease_burden/global/en/index.html
This journal agrees with Forbes as "Heart Disease" being the most expensive in the UK: http://www.accessmylibrary.com/coms2/summary_0286-2712108_ITM
This article puts heart disease in Australia at $5.924 billion/year, while oral care was $5.305 billion: http://www.aihw.gov.au/publications/cvd/hcecd04-05/hcecd04-05.pdf
This appears to be the article cited by Forbes (for the US figures 2002) http://www.ahrq.gov/research/ria19/expendria.htm#diff4
The originally cited article does specifically state "Caries is indeed the most expensive human disease in terms of direct costs.". The phrase "and costing society more to treat than any other disease" isn't indicative of direct costs, and incorrectly suggests broader societal costs. I don't think direct costs are appropriate for an encyclopaedia article, and we should only cite this if there is evidence that tooth decay is actually the highest costing disease. (the WHO appraisal doesn't seem to support this) Bitcloud1 (talk) 13:39, 15 October 2009 (UTC)
Recent edits
While some of Bitcloud1 (talk · contribs)'s recent edits may be helpful, I recommend that most of them be reverted because improper sources are being used, and it seems s/he may be using abstracts rather than relying on full articles. I also left Bitcloud a WP:3RR reminder, as the account was registered right after I reverted 118.208.108.188 (talk · contribs · WHOIS) twice, and is making similar edits. Hopefully the notification will suffice, and a checkuser won't be needed. SandyGeorgia (Talk) 14:31, 15 October 2009 (UTC)
- I don't recommend we blanket revert edits. These are all legitimate, unbiased edits backed up by legitimate citations. If anyone would like to modify citations to point to full articles rather than abstracts, they are welcome to do so. I will try to correct this minor administrative technicality as well.
- Meta: I made two edits before logging in. My old account is attached to my old email address, so i was forced to create a new account when I noticed the omissions on this article. (though I really feel that this is irrelevant. The edits are legitimate and are cited.)
- Please discuss any issues with any of the changes in discussions.
- Bitcloud1 (talk) 14:53, 15 October 2009 (UTC)
- Then please be aware that 3RR applies to all of your edits; you may have already violated it. If you have, you can avoid being blocked by reverting your edits post-haste. SandyGeorgia (Talk) 15:04, 15 October 2009 (UTC)
- I'm assuming you're talking about the "and costing society more to treat than any other disease." section. This citation is inaccurate and misleading by anyone's account. I can't revert this because it is an inaccurate statement. If anyone feels this to not be the case, the topic is "Highest disease cost uncited." in discussions. Let's add it back in if information comes to light suggesting tooth decay to be the highest societal cost amongst diseases.
- Re: 3RR. I have made two reverts, the second after comprehensively citing sources for the edit I originally made. The other revision was flagged as an "undo" (because i entered the edit through the "undo" link), but was a simple edit/rewrite removing the specific aspects you objected to. I hope you understand, this was not a "war" revision. It was simple collaborative editing. Bitcloud1 (talk) 15:29, 15 October 2009 (UTC)
- The cited source, Sheiham 2001 (PMID 11683551), clearly supports the claim that dental caries costs society more to treat than any other disease. It says, for example, "Caries is indeed the most expensive human disease in terms of direct costs." (p. 569). I don't know what the phrase '"Highest disease cost uncited." in discussions' is referring to. Eubulides (talk) 20:53, 15 October 2009 (UTC)
- This is incorrect. The discussions clearly discusses the costs of diseases. Heart disease is listed as the highest by many sources, including the WHO. "direct costs" are not "societal costs". Please revert this deletion. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
I have undone this edit. I can't make sense of the edit summary ("removed reference to animals and "weasle words") as the edit didn't remove anything and added words rather than fixing "weasel words".
- No, this edit reduced the sentence (paraphrased) "similarly there is an increase in levels of fluoride in the blood, and..." to "Similarly there is an increase in levels of fluoride in the blood.". Where there is mention of fluoridated water increasing levels of fluoride in the body, if a specific body area (saliva) is mentioned, then other specific body areas should also be mentioned. If no specific areas are mentioned, it should read "increased levels in the body". Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
- The text introduced "maximum safe" into the "level of fluoride". This is not supported by the source, which says: "The optimum water fluoride concentration will normally be within the range 0.5-1.0 mg/l."
- The text introduced "in an attempt" wrt reducing tooth decay. Those words imply a belief that is not proven to be substantiated. This is false and not supported by the source which clearly says water fluoridation is effective at preventing caries.
- The assumption is that it by default will reduce tooth decay. Vaccines are used in an attempt to immunise against disease. Police speed checks are used in an attempt to reduce road fatalities. Water fluoridation can only ever be "in an attempt" to reduce tooth decay. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
- The text removed "naturally occurring" wrt defluoridation. That was not helpful.
- This article isn't about "naturally occurring" fluoridation. De-fluoridation has also been needed in non-naturally occurring water supplies. This should be corrected. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
- The text introduced the sentence "Similarly, it creates an increased level of fluoride in the blood." into the lead, sourced to a primary research paper. The WP article does talk about fluoride being absorbed into the blood and indeed deposited in the bones. It uses a better source. I don't quite know what "Similarly" is meant to imply as there's nothing similar about it. If we are going to cover systemic absorption of fluoride in the lead, we should use better sources and revise the wording and possibly position within the lead. For example, it is not clear to the reader why this should be relevant at this point. I think Eubulides should be able to suggest something here.
Colin°Talk 16:28, 15 October 2009 (UTC)
I have undone this edit, which had the summary "Removed weasle words and restored impartiality to the section regarding "dental fluorosis"".
- The text removed the qualification on fluorosis: "most of this is mild and usually not considered to be of aesthetic or public-health concern". This qualification is supported by the source, which says "the majority of this fluorosis was mild and would not be considered to be of aesthetic concern." The "most" is not a weasel word here as it is equivalent to "majority of". The aesthetic concerns (or lack of) are not the opinions of pro-fluoride writers -- they are a result of questioning people (e.g. teenagers) on whether they regard the effects as of any aesthetic concern. One can't "restore impartiality" by removing bits of the text one doesn't like. If our sources say it generally isn't of aesthetic concern, then this can and should be reflected in our text.
Colin°Talk 16:41, 15 October 2009 (UTC)
- This uses biased, subjective language. Perhaps better wording would be "Surveys conducted suggest that most of this is mild and usually not considered to be of aesthetic or public-health concern" Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
I have undone this edit, which had the summary "Clarified the statement "has substantial advantages". Now specifically addresses the advantages.".
- The text replaced "Water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk." with "Water fluoridation, when feasible and culturally acceptable, can lead to a substantial decrease in tooth decay, especially for subgroups at high risk." This is not the point of the sentence. The point of the sentence, is that it has advantages over the other means of delivering fluoride or improving dental health, and those advantages are particularly seen in certain subgroups at high risk. Nobody needs reminding, at this stage, what the aim is ("a substantial decrease in tooth decay"). Colin°Talk 18:22, 15 October 2009 (UTC)
- This needs to be clarified in this case. It's ambiguous in its current wording. We should replace "has substantial advantages" with "has substantial advantages over other fluoridation methods".
- Colin, as Sandy has pointed out, there is a WP:3RR rule. You might need to address this. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
I undid this edit, which added material supported by a news article about a fluoride overfeed in Australia. This overfeed isn't particularly notable compared to the ones already mentioned (no injuries were reported, as opposed to the incidents already noted, which included many injuries and one fatality). It's better to use reliable secondary sources for material like this, to avoid problems with WP:WEIGHT and WP:RECENTISM; see WP:PSTS and WP:MEDRS. I also removed the insertion of the phrase "maximum safe" when talking about WHO suggestions; that WHO document is talking about recommended levels, not maximum safe levels. I removed a couple of insertion of "in humans" as the surrounding text is clearly already about humans (and the sources don't say "in humans", for the same reason, so we shouldn't either). And I changed an "effective" back to a "justified" because the cited source says "justified", not "effective" (see Talk:Water fluoridation/GA1 #Europe and Canada). I suggest that future edits that are likely to be controversial be discussed on the talk page first, to save us all some time and effort. Eubulides (talk) 20:53, 15 October 2009 (UTC)
- I disagree with a 20 times over the limit fluoridation news article not being notable. Please revert this edit, or include this information in another way. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)
- I respectfully but firmly disagree. There are countless public water supply systems in the world and some small percentage are almost always botching something. In my area we see spikes in chlorination. The acute toxicity of fluoride indicates that it is grams per liter is when things get dangerous, not milligrams. The LD50 for sodium fluorosilicate in rats is 125 mg/kg (that's a big rat!, but seriously...) for a 50 kg person that LD50 translates to several grams per liter. So the incident in Brisbane is a non-event for most neutral readers (i.e., those neither for or against fluoridation). In fact, the absence of anything particularly bad happening with a spike in fluoride if anything, undermines some of the alarmist rhetoric on this page. --Smokefoot (talk) 00:01, 16 October 2009 (UTC)
- Perhaps a subpage or subcategory of "incidents of accidental over fluoridation" should be made rather than just ignoring these news items. It was a national news item. Your comments lead me to believe that it may be a commonly reported occurrence, in which case it definitely needs to be addressed. If the other illnesses are a result of negligence in fluoridation, then all incidences of negligence are notable. Bitcloud1 (talk) 02:02, 16 October 2009 (UTC)
- I respectfully but firmly disagree. There are countless public water supply systems in the world and some small percentage are almost always botching something. In my area we see spikes in chlorination. The acute toxicity of fluoride indicates that it is grams per liter is when things get dangerous, not milligrams. The LD50 for sodium fluorosilicate in rats is 125 mg/kg (that's a big rat!, but seriously...) for a 50 kg person that LD50 translates to several grams per liter. So the incident in Brisbane is a non-event for most neutral readers (i.e., those neither for or against fluoridation). In fact, the absence of anything particularly bad happening with a spike in fluoride if anything, undermines some of the alarmist rhetoric on this page. --Smokefoot (talk) 00:01, 16 October 2009 (UTC)
- "justified" section. Why does this belong in the lead? Citation is a subjective work, and includes the subjective terms "may be". I don't feel this is appropriate for the lead. Bitcloud1 (talk) 23:36, 15 October 2009 (UTC)
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