infant formula fluorosis

7/31/2019 Infant Formula Fluorosis

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Response to British Medical Journal article: Adding fluoride to water supplies. Cheng et al.BMJ.2007; 335: 699-702 (6 October)http://www.bmj.com/rapid-response/2011/11/01/fluoridation-time-reevaluate

Fluoridation: Time to reevaluate 19 October 2007

Bill Osmunson DDS, MPH,Cosmetic Comprehensive DentistBellevue, Washington 9804

The BMJ needs to be commended for further opening the scientific debate on fluoridation. For the first 25 years of dental practice Ipromoted the addition of fluoride to water, in part because I thought I could see the difference between those on fluoridated waterand those without. Unfortunately, I was actually comparing socioeconomics rather than fluoridation. As more patients have come in

requesting extensive cosmetic dentistry, sometimes costing tens of thousands of dollars to correct their dental fluorosis, I decided itwas time to look at the sources, dosage, efficacy, and benefits of ingested fluoride. Looking at the current literature was like a knee inthe gut.1

FLUORIDE EXPOSURE: Clearly fluoride exposure has increased over the last 60 years. Dental fluorosis is up 50% to a third ofchildren. More dental and medical products and medications contain fluoride. Permitted residue levels from fluoride based pesticidesand post-harvest fumigants (ProFume, Dow Agro Chemical) have significantly increased in just the last decade. Mechanicallydeboned meat can be much higher in bone/fluoride content. Grape products and some tea have high levels of fluoride. Apparently noagency is the legal intermediary, the doctor, responsible for monitoring the publics total exposure to fluoride. Some people are more

sensitive to chemicals and unable to excrete excess fluoride. Synergistic effects from groups of chemicals are relatively unknown. Itappears any benefit of fluoride is from a topical application and not from ingested fluoride.

BENEFITS OF FLUORIDATION: Evidence forwhether an intervention works when applied in the community at large is referred toas its effectiveness. . . . Effectiveness studies more accurately reflect results that may be expected from the implementation ofinterventions.2 If fluoride actually provides a life time reduction of dental decay, certainly after 60 years of fluoridation we should

see clear evidence of effectiveness. Unfortunately, comparing developed countries finds all have reduced dental decay to simi lar levelsregardless of fluoridation. Comparing states within the USA based on the percentage of the population fluoridated finds no improveddental health or reduction of decay regardless of the percentage fluoridated. Comparing similar states such as Washington Sta te (59%fluoridated) with Oregon State (19% fluoridated) actually finds slightly better dental health in the less fluoridated Oregon. Comparingcounties within states finds similar oral health, with similar socioeconomics, regardless of fluoridation.3 Studies on fluoridation havenot included the confounding factor of delayed tooth eruption or looked at life time benefits.4

It is a flawed assumption to expect fluoridated children with fewer cavities will "therefore" have a life time of fewer cavities. Severalstudies have actually found an increase in dental decay and tooth loss with fluoridation. Without clear, undisputed, life time benefitsfrom fluoridation, any risk or expense is unacceptable. Communities have stopped fluoridation with no increase in dental decay.5 Theexperiment of fluoridation is currently being promoted without good scientific and ethical review of continued life time benefits.

The US National Academy of Sciences 2006 report confirmed potential benefits from fluoridation are during the development of the

tooth, up to about age 8. It makes no sense to have a lifetime uncontrolled dose of fluoride for everyone when the potential benefits areonly up to age 8. Lifetime exposure must be considered.

DENTAL RISKS OF FLUORIDATION: As a Cosmetic Dentist, it is not uncommon to have patients receive gorgeous porcelainveneers to correct their dental fluorosis, white and brown damage from too much ingested fluoride. Costs range from several hundreddollars to well over $25,000 and need to be retreated every 10 to 20 years for life time costs which may exceed $100,000 per person.With a third of children having dental fluorosis the true costs for cosmetic damage to teeth alone is in the trillions of dollars A side
http://www.bmj.com/rapid-response/2011/11/01/fluoridation-time-reevaluatehttp://www.bmj.com/rapid-response/2011/11/01/fluoridation-time-reevaluatehttp://www.bmj.com/rapid-response/2011/11/01/fluoridation-time-reevaluate


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The US Center for Disease Control and American Dental Association have cautioned infants should not be given fluoridated water orfluoridated water be used for making infant formula.7 More than 3 out of 4 infants receive formula. Consider that all are medicatedwith fluoridation, yet the water is not safe for our most vulnerable, our babies. We are now asking moms to haul their infant, its food,toys, clothes, and now water. Parents in third world countries can usually boil their water to make it safe for infants, but manycommunities consciously put chemicals in the public water which cant even be boiled out or traditional filters used to make it safe forinfants.

The biggest problem in the US scientific community is the fear Universities, Medical and Dental Associations and Journals have inpermitting discussion, debate and scientific review of fluoridation. One state medical association requested $50,000 for a short privatepresentation of concerns. Others permit review only by their legal counsel. The BMJ should be commended for their willingness to dowhat few other scientists are willing to do, open scientific discussion.

Bill Osmunson DDS, MPH Aesthetic Dentistry of Bellevue [email protected]

1. The CDC also references Horowitz and Ismail 1996, Johnston 1994, Ripa 1990, Stookey and Beiswanger 1995, however all these

reviewed topical application of fluoride, not the addition of fluoride to water. http://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htm

2.http://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htm

3. National Survey of Children's Health.http://mchb.hrsa.gov/oralhealth/portrait/1cct.htm

http://www.cdc.gov/oralhealth/waterfluoridation/fact_sheets/states_stats2002.htm---(No longer there)

The National Survey of Children's Health 2003. Rockville, Maryland: U.S. Department of Health and Human Services, 2005

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau

http://www.doh.wa.gov/cfh/Oral_Health/Documents/SmileSurvey2005FullReport.pdf---(No longer there)

http://www.oregon.gov/DHS/ph/oralhealth/docs/databook.pdf#search='Oregon%20Decay%20experience

BRFSS 2002 http://www.dhs.state.or.us/dhs/ph/chs/brfs/02/orahea/dentvisi.shtml---(No longer there)http://apps.nccd.cdc.gov/brfss/display.asp?state=WA&cat=OH&yr=2004&qkey=6610&grp=0&SUBMIT4=Go Sample size OR 3509and WA 12,926 2004 data

National Survey of Children's Health.http://mchb.hrsa.gov/oralhealth/portrait/1cct.htm U.S. Department of Health and HumanServices, http://www.fluoridationcenter.org/papers/2002/cdcmmwr022102.htm---(No longer there)

http://quickfacts.census.gov/qfd/states/41000.html

4. Our analysis shows no convincing effect of fluoride-intake on caries development." Komarek A, et al. (2005). A Bayesian analysisof multivariate doubly-interval-censored dental data. Biostatistics 6:145-55.

5. Kugel (sp) and Fischer 1997, Sepp et al. 1998

6.www.nap.edu/catalog/11571.html Fluoride in Drinking Water: A Scientific Review of EPAs Standards 2006

7.http://www.cdc.gov/fluoridation/safety/infant_formula.htm www.ada.org see also Pizzo G, et al Community water fluoridationand caries prevention: a critical review, Clin Oral Investig. 2007 Feb 27.
http://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htmhttp://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htmhttp://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htmhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://www.oregon.gov/DHS/ph/oralhealth/docs/databook.pdf#search='Oregon%20Decay%20experiencehttp://www.oregon.gov/DHS/ph/oralhealth/docs/databook.pdf#search='Oregon%20Decay%20experiencehttp://apps.nccd.cdc.gov/brfss/display.asp?state=WA&cat=OH&yr=2004&qkey=6610&grp=0&SUBMIT4=Gohttp://apps.nccd.cdc.gov/brfss/display.asp?state=WA&cat=OH&yr=2004&qkey=6610&grp=0&SUBMIT4=Gohttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://quickfacts.census.gov/qfd/states/41000.htmlhttp://quickfacts.census.gov/qfd/states/41000.htmlhttp://www.nap.edu/catalog/11571.htmlhttp://www.nap.edu/catalog/11571.htmlhttp://www.nap.edu/catalog/11571.htmlhttp://www.cdc.gov/fluoridation/safety/infant_formula.htmhttp://www.cdc.gov/fluoridation/safety/infant_formula.htmhttp://www.cdc.gov/fluoridation/safety/infant_formula.htmhttp://www.ada.org/http://www.ada.org/http://www.ada.org/http://www.cdc.gov/fluoridation/safety/infant_formula.htmhttp://www.nap.edu/catalog/11571.htmlhttp://quickfacts.census.gov/qfd/states/41000.htmlhttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://apps.nccd.cdc.gov/brfss/display.asp?state=WA&cat=OH&yr=2004&qkey=6610&grp=0&SUBMIT4=Gohttp://www.oregon.gov/DHS/ph/oralhealth/docs/databook.pdf#search='Oregon%20Decay%20experiencehttp://mchb.hrsa.gov/oralhealth/portrait/1cct.htmhttp://www2.nidcr.nih.gov/sgr/sgrohweb/chap7.htm


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