Talk:Fluoride toxicity

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Trace element meta-analysis?[edit]

This citation was added by Jinkinson to replace a non-WP:MEDRS-compliant citation:

  • Tang, Qin-qing; Du, Jun; Ma, Heng-hui; Jiang, Shao-jun; Zhou, Xiao-jun (10 August 2008). "Fluoride and Children's Intelligence: A Meta-analysis". Biological Trace Element Research. 126 (1-3): 115–120. doi:10.1007/s12011-008-8204-x. 

Just reading through the abstract gives me grave concerns about this. They specifically state "Further search was undertaken in the website because this is a professional website concerning research on fluoride." is the website of The International Society for Fluoride Research, which is specifically mentioned as a questionable organization on QuackWatch. I don't know anything about Biological Trace Element Research, but it doesn't seem like it could be very high quality based on this article... 0x0077BE [talk/contrib] 20:21, 6 November 2014 (UTC)

I recently saw that same article linked in an online discussion off-wiki, looked it up, and also agree that it is a very dubious source for this article. The journal looks like a dog of a journal. -- WeijiBaikeBianji (talk, how I edit) 22:00, 6 November 2014 (UTC)
I have to agree, I have looked up that particular journal on a completely unrelated topic, and found the journal quality lacking. I would support removal. Yobol (talk) 22:06, 6 November 2014 (UTC)
Alright, I guess you have a point. Perhaps it's because the journal's impact factor is only 1.608. [1] This might mean we should have a rule about minimum impact factors for journals whose articles we can cite, because it's published by a reputable publisher, Springer, so you would expect it would be at least a halfway decent journal otherwise. If this is the problem, I will try to avoid adding papers from low impact factor journals in the future. Jinkinson talk to me 02:06, 7 November 2014 (UTC)
FWIW - Quackwatch isn't exactly the epitome of impartial decision making. Quackwatch has a much more dogmatic and derisive tone than many of those it attacks. That said, yes - there are tons of quacks and pseudo science sites. However, I posit that a retired psychiatrist who is making almost as much money as Kevin Trudeau did, is just the other side of the same coin. Consequently, I would look at both sides but not make any decisions based on what Stephen Barrett thinks. Another aside: I get irritated by cheaply formatted material, too. Be sure you are reacting to the quality of the article and not the quality of the formatting. Seabreezes1 (talk) 17:21, 6 December 2014 (UTC)
Barrett, making lots of money? You're joking, right?! I really doubt he sells very many of his books (they aren't a popular category of literature), and lawyer fees are usually pretty high, although I wouldn't be surprised if he has lawyers who don't charge very much, simply because they believe in his work. The frivolous lawsuit which currently attacks him can't be cheap. -- Brangifer (talk) 17:34, 6 December 2014 (UTC)
Good point..... he does spend a lot in legal fees. Proves my point, his opinion isn't exactly one to hang your hat on.
This paper has been retracted: Larslarsen~enwiki (talk) 05:03, 14 April 2016 (UTC)

Edit War[edit]

Geez, even as I'm typing in the references, my edits, which I try to do in several passes, are getting undone. All I want to do is add a coupled referenced sentences. I don't even realize it till later, which probably makes it look like I'm being equally aggressive.

on KIDNEYS - add a couple of sentences to an existing article about dosage, referencing specific NRC pages. NRC is already a reference in this paragraph
Our fluoride dosage is determined by our intake of fluoride from all sources, including but not exclusive to fluoridated water.[1]:23 Within the recommended dose specific to age, no adverse effects are anticipated for those healthy renal function, but chronic ingestion in excess of 12 mg/day are expected to cause adverse effects in even the most healthy individual.[1]:281 There are insufficient studies on the impact of long term exposure to low dose fluoride exposure on susceptible populations.[1]:340-353 Those with impaired kidney function are more susceptible to adverse effects. [1]:292
on TEETH - about disproportionate racial harm, FOIA documents from October 2014
However, Public Health Service and Center for Disease Control records reveal a racial disparity in the incidence and severity of dental fluorosis. Per CDC records from 2012, African Americans in optimally fluoridated communities suffered from 58% dental fluorosis compared to the 36% dental fluorosis experience of their white neighbors. Moreover, most of the moderate to severe fluorosis was seen in the non-white populations. [2] [3][4]

If Yobol doesn't like Nidel as a reference, fine. I added the direct link to the FOIA documents from HHS, CDC, etc. too. I'm open to constructive criticism to improve this, but blanket erasures aren't in the collaborative Wiki spirit. Seabreezes1 (talk) 17:46, 6 December 2014 (UTC)Seabreezes1 (talk) 17:55, 6 December 2014 (UTC)

Some of the issues... style-wise, please read WP:MEDMOS - as an encyclopedia we don't refer to "we" and "our". Also per the more general WP:MOS sentences should be active voice as much as possible. On sourcing, the FOIA documents are not reliable- these go through several hands and it is impossible to verify if they are original or not.... I have used them, but only when they are posted auxiliary to an article by a very reliable source (like the NY Times) that we can generally count on having checked their authenticity (but even with accomplished news organizations there can be trouble, as happened to Dan Rather with the GW Bush military service documents). So no, these FOIA documents posted by some law firm are not reliable. Jytdog (talk) 18:00, 6 December 2014 (UTC)
Thank you Jytdog. That's valid and sane.
On kidneys.... so if I remove "our" (implying human) from that one sentence, can it stay: "Fluoride dosage is determined by individual intake of fluoride from all sources, including but not exclusive to fluoridated water...."
On teeth: How about The New American or PR Newswire articles? I thought a direct link to Nidel or the released docs was better. Then there is press from the King family, UN Ambassador Young and the Black Pastors, but that's more press release stuff. News articles: or
Or do I need anything more than the 1999 Kumar article? I think I do, but am not interested in continuing if anything I suggest is going to get wiped out. Perhaps you can find another reference on the Civil Rights end of this which is gathering steam. We could wait for it to make the NY Times, but that doesn't seem right. On the science end, there are indications of this pattern in other articles, but its not the focus. Seabreezes1 (talk) 18:21, 6 December 2014 (UTC)
Your content includes "There are insufficient studies on the impact of long term exposure to low dose fluoride exposure on susceptible populations" cited to a whole chapter of the NRC report. Where precisely in the NRC report to find that? With respect to the flourosis - the 1999 article is a primary source an old one at that. Nobody has discussed racial differences, not even the NRC report from 7 years later? Jytdog (talk) 18:28, 6 December 2014 (UTC)
The New American is the magazine of the John Birch Society, so not a RS. (You shouldn't be reading it at all. It's poison for the mind.) PRNewswire isn't either, as literally anyone can post content there and make it look like an official news release. Lots of fringe sources use it for that purpose.
The use of FOIA content (and things like court documents) in this manner is considered WP:OR. Unless it is also mentioned in a secondary/tertiary RS, we often can't use such primary sources here. It's the secondary source which provides a context other than the work of editors here, which is why "We could wait for it to make the NY Times, but that doesn't seem right" is wrong. It is exactly by waiting that we avoid OR. Otherwise, primary sources like that can be included when backed up by previous mention in RS. For example, if the NYTimes were to mention it, then we could also use it, but, to avoid problems, it's best to keep the two references bundled together. We are supposed to stay behind the curve, not get ahead of it. You also need to follow WP:MEDRS more closely, where publication in a peer reviewed journal isn't usually enough. One needs reviews of multiple properly conducted and properly published research projects.
Otherwise, carrying on this discussion is the way we deal with controversial content. This is how collaboration happens. We discuss, modify, and end up with a compromise, and that content is something most editors will defend. You won't have to watch over the content you have added, fearing it will be deleted. Other editors will also protect it. -- Brangifer (talk) 19:21, 6 December 2014 (UTC)
Response: The racial differences pop up as a line here and there, dating back to the original studies that said things like they were treating the "Negro" children differently because it was "common knowledge" that they had stronger and better teeth that were more resistant to decay, followed up by news releases on the extremely poor situation with Black Americans and Native Americans re gum disease and cavities, especially in fluorinated big cities and fluoridated reservations.... with the occasional graph showing the high fluorosis rates. Wasn't on the NRC radar in 2006, but it began building steam in 2011 and got a boost this October with the FOIA release. However, the sum of the material over the decades consistently indicate that some people are more susceptible to low dose exposure for whatever reasons. More specifically:
The NRC report says that in several places, the entire last chapter I referenced is schooling the EPA on how they should be doing things.
- Exposure: Talks about how water fluoridation is number one, but all sources need to be considered when considering MCLG. Page 24
- High intake groups "defines sensitive subpopulations in terms of either their response (more severe response or a response to a lower dose) or their exposure (greater exposure than the general population). Hence, it is appropriate to consider those population subgroups whose water intake is likely to be substantially above the national average for the corresponding sex and age group....." Page 30
- "In patients with reduced renal function, the potential for fluoride accumulation in the skeleton is increased" Page 172
- Accumulation in children and kidney patients: "In sum, although the data are sparse, severe renal insufficiency appears to increase bone fluoride concentrations, perhaps as much as twofold. The elderly are at increased risk of high bone fluoride concentrations due to accumulation over time; although less clear, decreased renal function and gender may be important." on Page 100-103
Perhaps the best document is the 2011 comments from NRC Scientist, Dr. Kathleen Thiessen, to the EPA in response to their non-responsive response to the 2006 report. It was a paper submission. Dr. T was asked to submit it to those working on Pesticides, too, so you can download it from that site. The first page explains the original purpose of the report and why it is being sent here. She quotes the 2006 document, too:!documentDetail;D=EPA-HQ-OPP-2011-0173-0009
- See bottom of page 12 and top of page 13 where she references the 2006 study.
- Also page 14 she says "In fact, information in the NRC report indicates that some adverse health effects can reasonably be expected at exposure levels anticipated for people drinking artificially fluoridated water. The NRC report also brings up the largely unstudied hazards that are associated with use of silicofluorides for fluoridation of drinking water."
Other quotes from 2011 comments referencing 2006 report:
- "adverse health effects can be expected to occur in at least some individuals when estimated average intakes of fluoride are around 0.05 mg/kg/day or higher (NRC 2006; 2009); in other words, a LOAEL for some adverse health effects is lower than EPA's new RfD, which is supposed to protect the population, including sensitive subgroups, from deleteriouseffects during a lifetime (EPA 2009; 2011d). For persons with iodine deficiency (one example of a sensitive subgroup), average intakes as low as 0.01-0.03 mg/kg/day could produce effects (NRC 2006)."
- "The NRC's findings (NRC 2006) indicate that the ATSDR’s MRL is not protective enough, and thus EPA's RfD is even less protective. The available studies consider fluoride intake only in terms of the concentration in the local drinking water, and most use fluoridated water (1 mg/L, corresponding to an average daily intake of 0.03 mg/kg/day for adults) as a control. Thus there is probably considerable overlap in exposures between groups, making effects more difficult to distinguish, and the entire dose response range of interest has not been well studied"
- Dr. T lists a great deal of "optimal water fluoridation" studies and concludes, "The available data, responsibly interpreted, indicate little or no beneficial effect of water fluoridation on oral health. EPA should not assume or suppose beneficial effects of community water fluoridation in evaluating the health risks from fluoride in drinking water." Another NRC scientist, Dr. Hardy Limeback, former head of Preventive Dentistry at the Univ of Toronto, has written similar statements and published studies specific to bone. Seabreezes1 (talk) 19:57, 6 December 2014 (UTC)
Thanks, Brangifer. I agree those news sources aren't particularly good, and I don't read them or any of the popular rags.... but sometimes there is a hit on a topic that interests me. That's why I thought the law firm would be a better source. I followed the references. However, I don't know if publishing this in wiki is ahead of the curve. I've also seen this racial disparity noted in 1950s science, it's just never been front and center, only an aside. It's the news item that is shining the light on this scientific footnote. Despite my wordiness on Talk, my preference would be to simply have the occasional fair and defensible sentence in the article that acknowledges that there is reputable scientific debate on this topic, albeit with the CDC and ADA taking a dogmatic stance. Now where does this leave me? (talk) 20:15, 6 December 2014 (UTC)

Question: These are my three best go to articles. Are they wiki worthy? They do not address race, but they do address hypersensitivity and kidneys and are recent secondary sources:

  1. 2005 in Journal of American Physicians and Surgeons: 
  2. 2013 in Journal of Environmental and Public Health:
  3. 2014 in Scientific World Journal: 

Seabreezes1 (talk) 20:26, 6 December 2014 (UTC)

Seabreezes, so looking at these sources:
  • The Journal of American Physicians and Surgeons does not appear to be MEDLINE-indexed, which is often a red flag. I went to their website and the website of the associated organization, the AAPS, and the tone of their website was really alarming, it has a very strong political bent. Our article on the Association of American Physicians and Surgeons says it "is a politically conservative non-profit association founded in 1943 to 'fight socialized medicine and to fight the government takeover of medicine.'" So this is not going to be a dispassionate, even-handed source for information.
  • The Journal of Environmental and Public Health is MEDLINE-indexed but it's an open access journal, and I'll let others comment on that.
  • The Scientific World Journal isn't even listed in the PubMed NLM Catalog, so I'm starting from square zero, it's open-access and covers technology and general science in addition to medicine.
What this looks like is scraping around to try to find anything at all to support a predetermined conclusion, instead of reviewing the sources broadly, looking at the best-quality, most authoritative ones, seeing which messages they repeat across each other, and then using that to build article content. This is a backwards approach to article content development. Zad68 04:43, 7 December 2014 (UTC)

Please Note! When talking about fluoride you need to be specific. Fluoride means a compound containing fluoride. Each compound is different. Calcium fluoride is in the teeth. Sodium fluoride is rat poison Silica fluoric acid is toxic waste from fertilizer, aluminiun and nuclear refining. Look at the lethal dose of each and see how simple the problem is. — Preceding unsigned comment added by (talk) 09:30, 10 February 2016 (UTC)

Not really, but you are closing in on a primary school level of explanations. Indeed each compound is different. --Smokefoot (talk) 14:01, 10 February 2016 (UTC)

  1. ^ a b c d National Research Council (2006). Fluoride in Drinking Water: A Scientific Review of EPA's Standards. Washington, DC: National Academies Press. ISBN 0-309-10128-X. Lay summary (PDF)NRC (September 24, 2008). . See also CDC's statement on this report.
  2. ^ Nidel Law (2014). "Disproportionate Harm to African Americans". Retrieved 6 Dec 2014. 
  3. ^ :FOIA (2014). "Freedom of Information Act on Water Fluoridation's Disproportionate Harm to African Americans" (PDF). HHS, CDC, et al. communications. Retrieved 6 Dec 2014. 
  4. ^ :Kumar, JV (1999). Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. Community Dentistry & Oral Epidemiology 27:171-80.  Text "last2-Swango " ignored (help); |first2= missing |last2= in Authors list (help)

Statement about children and ingestion[edit]

The article currently makes the claim, "in one study 30% of children exposed to fluoride dental products via accidental ingestion developed mild symptoms." However, this is misleading because the study does not cover the broad category of "children exposed to fluoride dental products via accidental ingestion". The study only includes children who consumed enough fluoride products to warrant a call to a poison control center. One would certainly expect that this study group would show a significantly higher rate of symptoms than a group consisting of all children who ingested dental products. (The study also mentions ingestion of fluoride-containing insectide, not just dental products, but that's a minor point.) Therefore, I have removed the statement. Reference to this study should only be reincluded if it can be reworded to make it clear that the 30% figure applies only to a narrow "high-risk" study group. ChemNerd (talk) 17:22, 9 September 2015 (UTC)

I was trying to do that, but I think my sleep-deprived brain failed to handle it very well... Anyways, I agree completely. Garzfoth (talk) 19:56, 9 September 2015 (UTC) seems needed Ssscienccce (talk) 00:55, 12 October 2015 (UTC)

Using osteoporosis data in the choric exposure section[edit]

Fluoride salts of various sorts have been used for the treatment of osteoporosis for a long time now. Dosing regimes vary but patients often receive the maximum safe daily limit of active fluoride (~10 mg) for years. Data on the effects of this are available from clinical studies and meta reviews on osteoporosis. Would this data be suitable (and welcome) in the choric exposure section? --Project Osprey (talk) 14:50, 16 October 2015 (UTC)

Yes, if you've got good MEDRS sources, such a contribution would be significant, it seems. Thanks for bringing it up.--Smokefoot (talk) 17:48, 16 October 2015 (UTC)

Factual error - Brain damage - (Meta-Analysis citation contradicts statement in wiki article)[edit]

In the brain effects section of this article, only one statement is present "Some research has suggested that high levels of fluoride exposure may adversely affect neurodevelopment in children, but the evidence is of insufficient quality to allow any firm conclusions to be drawn"

The citation then links to a meta analysis that, while states in the background section that neurotoxicity may occur in adults, little is known about neurotoxicity in children. HOWEVER, the results section in the study finds: "The standardized weighted mean difference in IQ score between exposed and reference populations was –0.45 (95% confidence interval: –0.56, –0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas."

The meta analysis actually quite firmly indicates a strong relationship between fluoride ingestion and impaired neurodevelopment in children. — Preceding unsigned comment added by Lethalattraction (talkcontribs) 11:30, 14 November 2016 (UTC)

I just wanted to point out that out. — Preceding unsigned comment added by Lethalattraction (talkcontribs) 11:16, 14 November 2016 (UTC)

From the article's conclusion: "each of the articles reviewed had deficiencies, in some cases rather serious ones, that limit the conclusions that can be drawn". Alexbrn (talk) 11:40, 14 November 2016 (UTC)

That was in the discussion not the conclusion. The conclusion is that the results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. — Preceding unsigned comment added by Lethalattraction (talkcontribs) 11:47, 14 November 2016 (UTC)

The discussion actually begins with "Findings from our meta-analyses of 27 studies published over 22 years suggest an inverse association between high fluoride exposure and children’s intelligence. " — Preceding unsigned comment added by Lethalattraction (talkcontribs) 11:49, 14 November 2016 (UTC)

I'm sure it does "suggest" that, but the evidence is poor so conclusions aren't firm. Alexbrn (talk) 11:56, 14 November 2016 (UTC)

Not a fan of the citation. — Preceding unsigned comment added by Lethalattraction (talkcontribs) 12:01, 14 November 2016 (UTC)