Jump to content

Talk:Water fluoridation/Archive 4

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia
Archive 1Archive 2Archive 3Archive 4Archive 5Archive 6→Archive 10

As a public policy decision

The following text was recently added to the lead by an IP address:

As a public policy decision, the most important issue -- too often ignored -- is the choice of compound for this purpose. Whereas sodium fluoride (NaF) dissociates into its component elements and has little if any negative side effect, silicofluorides -- fluorosilicic acid (H2SiF6) or sodium silicofluoride (Na2SiF6) -- are toxins that do NOT dissociate totally (as shown by the German chemist Westendorf in 1975). Evidence of harmful effects of the residual (an oligomer of silicic acid) have been extensively documented in work by Coplan and Masters (see <www.dartmouth.edu/~rmasters). Since sodium fluoride was tested before use and is without known harmful side effects, it should be used for water fluoridation; silicofluorides were nominated for testing in 2002 by the National Toxicology Program of the U.S. (on the grounds that their "toxicology" was not adequately known), and without such testing claims of benefit need to consider apparent harmful side-effects (higher rates of learning disabilities, substance abuse and violent crime, each of which is plausibly due to greater impulsiveness in users due to the effects on the neurotransmitter acetylcholinesterase that were found by Westendorf).

There are several problems with this material:

  • It obviously advocates for the minority viewpoint that the choice of fluoridating compound has a significant health effect, violating WP:NPOV.
  • It puts material in the lead that does not summarize anything in the body, contrary to WP:LEAD.
  • It contains much material that is not sourced, contrary to WP:V.
  • The sources that it uses are primary sources. As per WP:MEDRS the article should use reliable secondary sources on the topic of silicofluorides, and should not use primary sources in an attempt to undermine the secondary sources.
  • This topic is already well covered in Water fluoridation # Safety, which cites both Pollick 2004 (PMID 15473093) and Macek et al. 2006 (PMID 16393670) on the topic, sources that are much stronger.

For this reason I moved the material into this talk page section, where it can be further discussed with the above points in mind. Eubulides (talk) 04:56, 11 August 2009 (UTC)

Posted by John Chalos

Posted by John Chalos August 24, 2009 john.chalos@gmail.com

Okay. It seems someone removed my post (based on an article I co-wrote with my father for the local newspaper and not otherwise copyrighted) saying it was copyrighted material. I'd like to make a plea for you to ignore the "regard" some have shown for this prize-winning entry to your encyclopedia. Popularity (especially, among those with vested interest) shouldn't be a motivating factor when determining how we educate our society. I think eleven EPA unions protesting water fluoridation before congress in 2005 and the National Academy of Sciences objecting to it in 2006 reflects credible dissent. I'd like the article to reflect those documented events. They were covered by many news sources but I guess posting links, quotes or excerpts would get this deleted since my post might contain some copyrighted material. Geez. Come on, this is censorship. For links to viable news sources, see the following pages: www.slweb.org, www.fluoridealert .org, www.nofluoride.com. —Preceding unsigned comment added by 9chambers (talk • contribs) 22:46, 24 August 2009 (UTC)

  • Yes, that material was removed because it was a duplicate of a 2006 copyrighted opinion piece signed by Pete Chalos in the Terre Haute Tribune-Star. Wikipedia cannot accept copyrighted material like that.
  • The above comments mischaracterize the 2006 National Academy of Sciences report, which explictly "does not examine the health risks or benefits of the artificially fluoridated water that millions of Americans drink".[1]
  • Fringe sites like fluoridealert .org are not reliable sources for medical facts and figures; see WP:MEDRS.
  • The letter from the EPA union does not appear to be notable, as nothing came of it. It was, if memory serves, led by a single antifluoridation member of the Washington DC local. However, if we can find reliable third-party sources establishing this letter's notability, it might be suitable for the Opposition to water fluoridation article.
Eubulides (talk) 23:12, 24 August 2009 (UTC)

Posted by John Chalos August 25, 2009 john.chalos@gmail.com

The 2005 congressional hearing was sparked by the objections of no less than eleven EPA unions representing 7,000 qualified professionals. The "leader" happened to be Dr. J. William Hirzy, Senior Vice-President and a chief toxicologist at the EPA. Nothing came of it but it was a significant protest. I appreciate you linking the NAS statement; I do think the article makes it clear that some in this country are being over-exposed to fluoride (in part) due to water fluoridation. I feel you're neglecting much of the information but you do seem to address some concerns in your "Opposition to water fluoridation" article. Lastly, I'd like to encourage you to take a moment to review the short video on the main page at www.fluoridealert .org. Thank you for listening and responding. —Preceding unsigned comment added by 66.64.210.50 (talk) 05:58, 25 August 2009 (UTC)

If you have a reference or citation to that 2005 congressional hearing, that would be worth adding to the Opposition to water fluoridation article. The NAS study was entirely about water naturally fluoridated to levels well above those recommended for fluoridated water, and the study itself explicitly rejected the claim that the study was about water fluoridation; see, for example, page 20 of the study, which said "The committee is aware that some readers expect this report to make a determination about whether public drinking-water supplies should be fluoridated. That expectation goes beyond the committee’s charge. As noted above, the MCLG and SMCL are guidelines for areas where fluoride concentrations are naturally high."[2] Eubulides (talk) 14:22, 25 August 2009 (UTC)

Like the person above

Like the person above, all my posts have been deleted from this discussion by someone. Again, diabetic people consume more water than normal, and daily as much fluoride from 1 ppm fluoride water as normal people on 2 ppm fluoride water. This disproves the extreme claim in 'fluoridation' that fluoridation does not increase risk of bone fractures. Consensus agreement exists that 2 ppm fluoride daily uptake for lifetime exposures reach thousands of mg/kg bone fluoride that increases bone fracture risk.

Will this post also be deleted? —Preceding unsigned comment added by 72.220.56.10 (talk) 04:07, 1 September 2009 (UTC)

  • The previous comment was evidently made by Rsauerheber (talk · contribs) without logging in. I'm not sure who its phrase "the person above" refers to. Rsauerheber, perhaps you could clarify? It would help to log in before posting, so that this sort of confusion could be avoided.
  • The point about diabetics is evidently original research, and by policy can't appear in Wikipedia articles.
  • Also, please read the policy page Wikipedia:What Wikipedia is not, particularly its section Wikipedia is not a soapbox. Following its device will help keep this thread on track. This talk page is for improving the article, not for serving as a general forum about water fluoridation. Off-topic threads are routinely deleted.
Eubulides (talk) 04:24, 1 September 2009 (UTC)
Understood.
1) Diabetic consumption data were published, reviewed by the National Research Council and re-published; it is not my original research.
2) There is total consensus that fluoride is NOT an essential element, because there is NO deficiency state that is reversed by the element alone that has ever been induced (The Merck Manual, 7th ed., 'Fluorine') This directly disproves the claim in 'fluoridation' that fluoride is added in a manner similar to that for iodide to reduce goiter. Such a claim is that of an extreme fringe minority who remain grossly mis-informed. If Wikipedia is interested in improving the article 'fluoridation', then at the very least could this false statement be deleted?
3) All artificial fluorides are listed on all poisons registries as rat poisons and insecticides (such as The Merck Manual 6th Ed., p. 2694; The Merck Index, 1976, etc.) while natural calcium fluoride is not listed on any poisons registry because its lethal dose is 30 times higher and is incapable of generating corrosive hydrofluoric acid HF in drinking water. The overfeed mentioned in 'fluoridation' used artificial sodium fluoride, which is 3,000 times more soluble (4.3 grams per 100 milliliters of water) than natural calcium fluoride (0.0015 grams per 100 milliliters). The poisoning of 300 people could not have happened if natural calcium fluoride (not a toxic compound below 5,000 grams per kg) were used for 'fluoridation' at 1 ppm. Natural calcium fluoride solubility prevents fluoride levels above 7 ppm fluoride in drinking water. Sodium fluoride and sodium fluorosilicate have lethal doses of a mere 0.125 grams per kg in tested animals, which compares to the lethality of arsenic.
The consensus viewpoint of the American people is against the artificial fluoride chemicals listed in the article 'fluoridation' that are injected into natural drinking waters, and in fact the people have voted more often than not against artificial fluoridation of water with these substances. They are widely used by water districts with support by city officials, rather than any perceived support of the people. (Nebraska state referendum voting data are on the public record, as are San Diego city voting data, but in most cases citizens are forbidden from voting on the procedure).
4) Teeth mottling according to scientific consensus is evidence of "consumption of too much fluoride" (Webster's 7th New Collegiate Dictionary), which is not a mineral nutrient in the first place (comment #2 above). Zipkin's studies published 1958 and recently reviewed proved that incorporation of fluoride sufficient to cause mottling of teeth already also caused incorporation of fluoride into bone that is irreversible (because calcium fluoride is so grossly insoluble) to thousands of times that above the level in fluoride water that caused such mottling. Accumulation progresses for the lifespan of the individual and the voting public should be given balanced credit for the choice and votes they have made. The article 'fluoridation' distorts the above 4 points of accepted fact.--Rsauerheber (talk) 05:41, 1 September 2009 (UTC)
For starters, please stop using spaces prior to your paragraphs - use the "Show Preview" button to see how your edits will turn out.
Secondly - exactly what changes do you propose to the article. All your paragraphs above are soapboxing and not helping the article.
Thirdly - the article states, The U.S. specifies the optimal level of fluoride to range from 0.7 to 1.2 mg/L (milligrams per liter, equivalent to parts per million), depending on the average maximum daily air temperature; the optimal level is lower in warmer climates, where people drink more water, and is higher in cooler climates.[31] The U.S. standard, adopted in 1962, is not appropriate for all parts of the world and is based on assumptions that have become obsolete with the rise of air conditioning and increased use of soft drinks, processed food, and other sources of fluorides. In 1994 a World Health Organization expert committee on fluoride use stated that 1.0 mg/L should be an absolute upper bound, even in cold climates, and that 0.5 mg/L may be an appropriate lower limit.[6] A 2007 Australian systematic review recommended a range from 0.6 to 1.1 mg - so your numbers are largely irrelevant in an article about Water Fluoridation and the dangers thereof.
Please cease with the soapboxing - start proposing where and what sections in the article you want changed, and your proposed changes. Shot info (talk) 05:51, 1 September 2009 (UTC)
I second this. Please propose specific changes to the article. What words would you change/add/remove and cite which reliable sources back up those changes. All the above is just soapboxing, wastes our time and will be deleted. Colin°Talk 09:02, 1 September 2009 (UTC)
#1 'fluoridation' statement-- 'fluoride can occur naturally in water in concentrations well above recommended levels, which can have several long-term adverse effects, including severe dental fluorosis, skeletal fluorosis, and weakened bones.[42] The World Health Organization recommends a guideline maximum fluoride value of 1.5 mg/L as a level at which fluorosis should be minimal.[50]' Proposed addition: This guideline however does not take into account the high volume of water necesary for subgroups of people, such as with diabetes who consume the same fluoride daily dose from 1 ppm water as non-diabetic individualse drinking 2 ppm fluoride water. [note to editor: diabetic subgroups (and others with health conditions requiring high volume water consumption) were not identified and were instead merely averaged among populations examined in reviews such as that of York]. This fact also applies to the statement that fluoride does not affect bone strength and to the statement that if has no other adverse effects. These claims do no and have never applied to diabetics and other high water volume consumers. This is because biologic effects depend on the total amount consumed, not simply the 1 ppm concentration, as noted in a separate statement in 'fluoridation'].
T #2 statement-- 'the recommended level should not be below 0.5 ppm fluoride' correctly describes the decision made by the WHO, but it renders the false conclusion that water supplies with 0.2 ppm are somehow then deficient, and also that fluoride ia somehow a necessary mineral nutrient, when (as stated in the earlier post) it is not. The U.S. FDA and NRC both recognize that no condition (including dental disease) is associated with complete absence of fluoride. A qualifier is thus necessary to avoid presuming the WHO are alone experts on this topic. Millions of people have zero cavities for lifetimes in areas with water fluoride below 0.5 ppm. —Preceding unsigned comment added by 205.153.156.222 (talk) 19:56, 1 September 2009 (UTC)
#1 proposes text that does not cite any reliable sources, and thus fails the verifiability policy. #2 does not propose any specific change to the article. Eubulides (talk) 23:53, 1 September 2009 (UTC)
#1 references are numerous but one is: Greenburg, L., Nelsen, C. and Kramer, N., Pediatrics 54:320, 1974. is one of many references on the subject. These authors also recommended that diabetes insipidus, renal medullary disease, nephropathy patients, and most with solute diuresis are associated with such large water volume consumption that fluoride water levels considered acceptable for normal individuals would be sufficient to cause fluorosis symptoms over long term drinking. In studies with only 2 ppm fluoride for chronic periods suchindividuals defeloped abnormal bone X-rays due to incorporated fluoride.
The change I propose for #2 is a statement that 'fluoride is not a mineral nutrient, and no pathologic condition of any kind is associated with the absence of fluoride intake. The complete absence of fluoride in a human being is not an abnormal condition. Fluoridation of a human being is not a physiologic requirement for human health. The absence of fluoride does not cause dental caries. Caries are caused by consumption of sugary foods and not cleaing teeth afterward. [note: many references to these effects were already deleted from earlier posts]. Either fluoridation is explained well with proper context from both sides (knowledgable opponents vs. others who want it) or it will simply remain as is, with inferences a reader will make that are not true. —Preceding unsigned comment added by 205.153.156.222 (talk) 00:33, 2 September 2009 (UTC)
  • Greenberg et al. 1974 (PMID 4414789) cannot possibly support #1, as #1 begins "This guideline ...", referring to the 2006 WHO guideline; and a 1974 paper of course cannot possibly make any statement about the 2006 WHO guideline. And, at any rate, there is no reason for the Water fluoridation article to cite a case report, a very low quality primary source, when far better sources are available. The Wikipedia guideline on medical sources says that case reports "are a form of anecdote and generally fall below the minimum requirements of reliable medical sources".
  • No reliable sources have been given for #2.
Eubulides (talk) 03:53, 2 September 2009 (UTC)
If the better source mentioned (which is not referenced in the post) claims that people with diabetes insipidus drinking 1 ppm fluoride do not compare to people drinking 2 ppm, then that source, not matter how reliable Wikipedia considers it, is wrong.
Since 'fluoridation' is not going to make the corrections required, then the article cannot be recomended for any of my students, family or friends because it implies that all bone cancers in victims drinking 1 ppm water as source of fluoride were not caused by that fluoride; and that the U.S. FDA is incorrect in its position that fluoride is not a mineral nutrient and is uncontrolled use of a drug. Water fluoridation has never been approved by the FDA in spite of recommendations by the WHO. The FDA, not the WHO, is correct in their assessment.
It is unethical for anyone to presume the right to control an entry called 'fluoridation' in a public encyclopledia as though their written statements are all correct, and yet this is exactly what is being done under the auspices of Wikipedia. Good luck to you. --205.153.156.222 (talk) 23:19, 2 September 2009 (UTC)
The ariticle is only controlled (limited, if you will) by what can be backed up by published reliable sources. It may well be that we lack good quality sources on some of these issues and consequently the article suffers -- but that is the consequence of Wikipedia's policies. If the article was written by a named authority on the subject, and reviewed by other named authorities, such as might occur on Britannica, then we could leave it to those experts to judge whether to include one aspect or another, and whether to give a particlar case report or opinion weight or not. As Wikipedia can be written anonymously by anyone, we require all facts to be sourced elsewhere -- not to Wikipedian's own opinions, whether those opinions seem reasonable or not.
The issue that certain groups of people with illnesses that lead them to consume large quantities of water, and consequently are at greater risk of fluorosis, is a valid one. It is similar to the issues of setting the levels of fluoridation in hot countries vs temperate countries. If a reliable source can be found for this aspect it could be mentioned, but it must not be specified in a way that criticises the WHO guideline limits unless the reliable source also criticised the WHO guideline limits.
A statement something like "Fluoride is not an essential mineral nutrient and the absense of fluoride does not cause dental caries" seems a reasonable addition, provided a reliable source can be found for this. I think it would be useful to clarify that fluoride is not like certain other minerals that we require in our diet. However the statement "no pathologic condition of any kind is associated with the absence of fluoride intake" is not true -- caries is associated with lower/no fluoride intake, just not caused by it. The other points you suggest to add merely labour the point, and the causes of caries are more complex than just sugary snacks and insufficient brushing.
Colin°Talk 14:31, 3 September 2009 (UTC)
Thanks for those helpful comments. Please see #Diabetes and #Essential nutrient below. Eubulides (talk) 19:16, 3 September 2009 (UTC)

Diabetes

For the topic of diabetes and water fluoridation, I searched the three best reviews we have on the safety of water fluoridation (the 2007 Australian review, Truman et al. 2002 (PMID 12091093), and the 2000 York review), and found no mention of diabetes or diabetics. This suggests that any concern about the effects on diabetics are not given much weight by mainstream medicine and science. Any other reliable sources in this area would be welcome; I did a brief Google Scholar search for recent sources and came up dry, though. Eubulides (talk) 19:16, 3 September 2009 (UTC)

Dietary Reference Intake

The material about Dietary Reference Intake mentioned in the previous thread should be added, since this provides important context for the existing treatment of daily intake of fluoride. To do this, in Mechanism, just before the sentence that begins "A rough estimate is that an adult in a temperate climate consumes 0.6 mg/day of fluoride without fluoridation", I propose that we insert the following text:

"The U.S. Institute of Medicine has established Dietary Reference Intakes for fluoride: Adequate Intake values range from 0.01 mg/day for infants aged 6 months or less, to 4 mg/day for men aged 19 years and up; and the Tolerable Upper Intake Level is 0.10 mg/kg/day for infants and children through age 8 years, and 10 mg/day thereafter."

citing:

Institute of Medicine (1997). "Fluoride". Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academy Press. pp. 288–313. ISBN 0-309-06350-7. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

Eubulides (talk) 08:05, 6 September 2009 (UTC)

Yes, a useful addition. Colin°Talk 00:03, 9 September 2009 (UTC)

Several controversial edits recently installed

This recent series of edits by Petergkeyes (talk · contribs), which follows on the similar edit made a few minutes earlier by 71.140.3.164 (talk · contribs · WHOIS), installs obviously-controversial material into the article without any previous discussion. These changes should be reverted, and the matter discussed first on the talk page, as the top of this talk page says. Eubulides (talk) 23:28, 8 September 2009 (UTC)

I've reverted the changes, which removed cited text. Please discuss what is wrong with the text you wish to remove. Colin°Talk 23:58, 8 September 2009 (UTC)

it is a chemical. the natural stuff is not, "adjusted," as sometimes erroneously claimed.

The stuff that is used to fluoridate drinking water is a chemical. This is irrefutable, and is not up for debate. Petergkeyes (talk) 23:38, 8 September 2009 (UTC)

Water is a chemical, for goodness sake. A serious encyclopaedia doesn't adopt dumbed-down Daily Mail language. The insertion of "chemical" is clearly an attempt to introduce POV via the lay assumption that "chemicals" are nasty and to be avoided. Colin°Talk 23:58, 8 September 2009 (UTC)
Fluoride is simply an element. The material added to the water is not simply an element. It is a compound chemical. I prefer the word chemical, but will settle for compound as a second choice. Petergkeyes (talk) 00:34, 9 September 2009 (UTC)
Why does this word need to be added? Shot info (talk) 00:38, 9 September 2009 (UTC)
Actually Peter, the location you have added it into is not needed. If you continue reading the paragraph you will see how the "addition of fluoride" is achieved. Likewise in the body of the article it is articulated more fully. The starting sentence how it was prior to your edit makes a nice neat summary of what "Water Fluoridation" actually is which is "Fluoridation of Water" by adding "fluoride" to "water". Shot info (talk) 00:43, 9 September 2009 (UTC)
For those who do not continue reading the paragraph, the first sentence is more accurate with the material identified. "Fluoride" is only a portion of what is added. It increases the accuracy to note the additive used, not just its targeted element. Petergkeyes (talk) 00:54, 9 September 2009 (UTC)
? Huh - increases accuracy? The first sentence is 100% accurate about Water Fluoridation prior to your edit - as the article is about ensuring fluoride is at a certain level in water - hence Water Fluoridation. BTW - have you read compound yet? Shot info (talk) 01:10, 9 September 2009 (UTC)
What is your argument, Shot? All of the additives used to fluoridate public water supplies are compound chemicals. Do we agree on that? 01:26, 9 September 2009 (UTC) —Preceding unsigned comment added by Petergkeyes (talk • contribs)
It's pretty easy to read what my argument - the article is about ensuring fluoride is at a certain level in water - hence Water Fluoridation. Shot info (talk) 03:22, 9 September 2009 (UTC)
  • The cited source, CDC 2001 (PMID 11521913), uses "fluoride" (not "fluoride chemical" or "fluoride compound") to define water fluoridation. Here's the quote: "Fluoridated drinking water contains a fluoride concentration effective for preventing dental caries; this concentration can occur naturally or be reached through water fluoridation, which is the controlled addition of fluoride to a public water supply." Generally speaking, all the reliable sources consistently focus on the fluoride, not the far-less-important detail of which compounds were used. Inserting "compound" or "chemical" in the lead sentence is de facto advocacy of the minority view that criticizes fluoride "chemicals" (or "compounds"), violating WP:NPOV. Let's stick with the established terminology used by reliable mainstream sources on the subject.
  • I again ask that potentially-controversial changes like these be proposed on the talk page first, not inserted unilaterally without discussion, as this change and this change were in the past three hours or so. Please see the top of this talk page.
Eubulides (talk) 03:53, 9 September 2009 (UTC)

Economics

I did a bit of reading to see what's new in water fluoridation, and found a couple of new papers on the economics that raise worthy issues that are not discussed in this article. First, water fluoridation results in less employment for dentists (this is a no-brainer, but I have not before seen a reliable source on this). Second, U.S. chidren who grow up in fluoridated areas earn more than those who do not; this effect is almost all in girls from poorer families, suggesting that it's due to a beauty premium when those girls grow up. I added a brief discussion of these topics and renamed Cost to Economics to reflect the now-broader topic of that section.

Eubulides (talk) 18:50, 31 August 2009 (UTC)

Can you prove that brushing their teeth didn't prevent the cavities instead? People who drink fluoridated water but don't brush their teeth get cavities, while those who brush their teeth and drink bottled or distilled water do not. Dream Focus 16:22, 10 September 2009 (UTC)
The source in question (Glied & Neidell 2008 [PDF]) states that because the study is based on data from a time before fluoridated toothpaste and sealants became popular, its results can be ascribed to water fluoridation as opposed to fluoridated toothpaste or sealants. Fluoridation #Economics does mention that the data were from 1957–1964; do you think that it should also mention that this predates fluoridated toothpaste and sealants? Eubulides (talk) 17:40, 10 September 2009 (UTC)

Essential nutrient

I investigated the topic of whether fluoride is considered to be an essential nutrient, and found that modern reliable sources do consider it to be one. Here is a quote explaining the situation:

"Furthermore, the actual function of an essential nutrient can vary categorically in at least two important ways. First, and most often, a nutrient is required as either a precursor, e.g., amino acids, or as a cofactor, e.g., B group vitamins, within a defined metabolic pathway.... The second metabolic action of an essential nutrient exists through its countering the deleterious action of an independent biological process. Here, the nutrient prevents a secondary biological process that would be harmful to the organism. For example, fluoride acts to prevent dental cavities by interfering with the action of microbial destruction of tooth enamel. Both oral cavity microbes and sugar are considered a part of a contemporary lifestyle; as such, dental cavities fall into the normal physiological arena. Where diets contain less sugar, the need for fluoride ceases." The authors give dietary fiber as another example of an essential nutrient in the second category. The source: Jones PJ, Varady KA (2008). "Are functional foods redefining nutritional requirements?" (PDF). Appl Physiol Nutr Metab. 33 (1): 118–23. PMID 18347661.

Several other recent and reliable sources list fluoride as an essential nutrient, including:

  • Bergman C, Gray-Scott D, Chen JJ, Meacham S (2009). "What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride?". Crit Rev Food Sci Nutr. 49 (2): 136–44. doi:10.1080/10408390701764468. PMID 18989832.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Lichtenstein AH, Russell RM (2005). "Essential nutrients: food or supplements? Where should the emphasis be?". JAMA. 294 (3): 351–8. PMID 16030280.

I did not find any recent sources disputing the classification of fluoride as an essential nutrient in typical Western diet. I did find a dispute in a much older paper: "There is some reluctance to classify fluoride as an essential nutrient." in Hartles & Slack 1959 (doi:10.1079/PNS19590020). However, this 50-year-old paper obviously does not reflect current thinking.

Given all the above, I propose appending the following sentences to the Mechanism section:

"Fluoride is an essential nutrient, but not in the most common sense as a precursor or cofactor of a metabolic pathway. Instead, like dietary fiber, fluoride prevents a harmful biological process. In fluoride's case the harm comes from a modern lifestyle involving sugar and oral microbes, and diets lower in sugar remove the need for fluoride."

citing Jones & Varady 2008. Eubulides (talk) 19:16, 3 September 2009 (UTC)

Eh, no. Fluoride has always been classified by nutritional science as "beneficial", not essential. To say otherwise is to misrepresent modern nutritional science and its classification scheme. For example, see the 2004 WHO draft paper on essential minerals in drinking water, page 12 (http://www.who.int/water_sanitation_health/dwq/en/nutoverview.pdf) which states that "the essentiality of fluoride for humans has not been proven unequivocally". I can also bring up my recent undergrad nutrition textbook, which states the exact same thing. Your research apparently completely missed the most key papers on this topic such as Tao and Suttie 1973. This is briefly reviewed in NRC 1989, which states that "these contradictory results do not justify a classification of fluoride as an essential nutrient". You say that these articles say that fluoride is essential - but you've got no quotes which say that exactly. Even your first quote is a roundabout way of proposing a nonmainstream (and highly illogical) view of what an essential nutrient is. Dietary fiber is not considered an essential nutrient either. II | (t - c) 19:53, 3 September 2009 (UTC)
I'm afraid that the sources listed in the previous comment are either out of date or not for citation.
  • Tao & Suttie 1976 (PMID 939992) is a 33-year-old primary source and is not reliable for the question as to whether fluoride is considered to be an essential nutrient now. Its contents make it clear that it's investigating whether fluoride is essential in the first (precursor-or-cofactor) way discussed by Jones & Varady, not whether fluoride is essential in the second (countering-deleterious-action) way. The proposed text addresses this point, by saying that fluoride is not essential in the first way.
  • The NRC 1989 report is a reasonable source for how fluoride was considered twenty years ago, but the old notion of Recommended Dietary Allowance (RDA) has been superseded by the newer notion of Dietary Reference Intake (DRI). I just now checked the USDA website and the latest tables (dated 1997) generated by the NRC do list fluoride requirements. Bergman et al. 2009 summarizes the work of the Food and Nutrition Board’s DRI committee, which has been reviewing this standard, and makes it clear that fluoride requirements will also be in the next version of the standard.
  • Given the above, I suspect that your nutrition textbook is relying on obsolete information; it wouldn't be the first time. But we could check this if you could supply the citation and quote from it, in particular, the sources that it cites to support its claims.
  • That 2004 WHO draft is explicitly not for citation; do you have something else recent from the WHO that can be cited?
  • "You say that these articles say that fluoride is essential - but you've got no quotes which say that exactly". Sure I do. The extended quote from Jones & Varady says "Furthermore, the actual function of an essential nutrient can vary categorically in at least two important ways. First,.... The second metabolic action of an essential nutrient exists through its countering the deleterious action of an independent biological process.... For example, fluoride acts to prevent dental cavities by interfering with the action of microbial destruction of tooth enamel." This clearly gives fluoride as an example of the 2nd category of essential nutrients.
  • "Even your first quote is a roundabout way of proposing a nonmainstream (and highly illogical) view of what an essential nutrient is." Nope, it's the current mainstream. And there's nothing illogical about it.
  • "Dietary fiber is not considered an essential nutrient either." It wasn't considered to be essential three decades ago, but it is now. For example, please see Gordon 2009, whose abstract begins, matter-of-factly, "Dietary fiber (DF) is an undefined nutrient, but an essential nutrient." That's just from a quick Google Scholar search of recent sources, but I'm sure more sources can be supplied.
Eubulides (talk) 20:55, 3 September 2009 (UTC)
The final citation to Olivares & Uauy is here. It says "the essentiality of fluoride for humans has not been proven unequivocally" (in fact, the weight is against it). Let's be clear about Jones & Varady: this is a speculative paper which proposes that plant sterols be considered essential because they are beneficial in reducing cholesterol. One could say the same about statins. There are tons of nonessential substances which are well-tolerated and beneficial. Such a position would probably be characterized by Quackwatch as a CAM hype. It essentially ignores the traditional distinction between essential and beneficial nutrients, and its proposal will most likely be ignored because so many nonessential substances are beneficial. As you note, the NRC 1997 committee did come up with DRIs for fluoride (similar recommendations for fiber exist). A letter was mailed to the NAS about the lack of clarification. The response .org/Alert/Canada/National/Clarification-on-fluoride-as-a-beneficial-element-and-not-a-beneficial-nutrient, by the President of the NAS and the President of the IOM, said "nowhere in the report is it stated that fluoride is an essential nutrient. If any speaker or panel member at the September 23rd workshop referred to fluoride as such, they misspoke. As was stated in Recommended Dietary Allowances 10th Edition, which we published in 1989: "These contradictory results do not justify a classification of fluoride as an essential element, according to accepted standards". Sometimes paper authors (even writing "reviews" OMG!) are able to sneak in opinions which don't really reflect mainstream "accepted standards". Sure, one can find numerous sources hyping dietary fiber who say it is an essential nutrient. But it's still not a traditional essential nutrient, and there are tons of Americans who live fairly happy lives on very little fiber. On the other hand, it's more like an essential nutrient than fluoride - one can be cavity-free quite easily without fluoride, whereas one will always be uncomfortable on the toilet without fiber. The old, traditional standards of nutrition are what should be used. And if an authority has not revised its statement, its original statement applies (as in the case of the NRC 1989). II | (t - c) 21:57, 3 September 2009 (UTC)
  • Thanks for the citation to Olivares & Uauy 2005. I agree that it is a better source.
  • Although Jones & Varady is explicitly speculative about plant sterols, it is explicitly not speculative about fluoride or dietary fiber: it gives them as examples of essential nutrients of the "countering the deleterious action" type.
  • Jones & Varady are not the only modern sources that use the more-expansive version of "essential" to mean "needed to promote optimum health" as opposed to "needed to survive". However, I agree that this use of the term is controversial among reliable sources, and that we should give greater weight to the consensus position. I'll propose a new draft in #Essential nutrient 2 below.
Eubulides (talk) 08:05, 6 September 2009 (UTC)

It is never as simple as you first think

Hmm. It is never as simple as you first think. I agree that undergrad textbooks aren't the best source for up-to-date knowledge/consensus. We do need to be careful we are classifying fluoride based on widespread consensus, otherwise we would need to say that it is a controversial topic. The classification of fluoride as an essential or as a beneficial nutrient is, I think, within the scope of this article. I'm glad to see ImperfectlyInformed and Eubulides conducting the sort of source-based discussion we should have on these talk pages. That's healthy. Colin°Talk 21:33, 3 September 2009 (UTC)

  • I did some more reading into the subject. It's quite a zoo. I looked for recent Google Scholar sources saying "fluoride is an essential nutrient" and found just one:
  • Widening the search to the past twenty years found some lower-quality sources not worth mentioning, along with one moderated discussion, namely Fürst P (moderator) (2000). "Moderated discussion". Am J Clin Nutr. 71 (6 Suppl): 1688S – 90S. PMID 10837317. It has this illuminating exchange:
Dr Harper
... What about fluoride? Is it a nutrient? A functional food? Is it just a natural product? We are not quite sure. Nevertheless, it is a substance that has an obvious and well-established beneficial health effect. I would separate the health effect from the pharmacologic effect. Thus, I might put protection of fluoride against tooth decay as a nonpharmacologic, but beneficial, health effect, and its effects at higher levels, in staining teeth or causing bone deterioration, as pharmacologic effects.
Dr Fernstrom
If it is not a nutrient per se, then that definition is not valid.
Dr Harper
That's the debate. We are not going to resolve it today, but some of us are not convinced that fluoride is an essential nutrient, yet we are convinced that it has a health effect.
Dr Fernstrom
Would you then call this, by definition, a pharmacologic effect?
Dr Hathcock
From a scientific viewpoint, it may not make much difference what we call it, but from a regulatory viewpoint, it is critically important. The definition can determine whether there is free access to a product or whether access will be by prescription only.
I also found another extremely dated source that talks about the controversy: Hegsted DM (1975). "Summary of the Conference on Nutrition in the Causation of Cancer". Cancer Res. 35: 3541–3. It says:
"There has been a long and continuing argument over whether fluoride is an essential nutrient, i.e., essential for life. This is a rather unproductive argument since the effect of fluoride on dental decay is obvious and its use in public health has nothing to do with our usual definition of essentiality. The fact is that it is essential for the maintenance of good dental health even though dental cavities might be avoided on low-fluoride diets if we could be nourished by by-passing the mouth."
This last comment essentially mirrors what Jones & Varady 2008 say in substance, even if it uses a different interpretation of the phrase "essential nutrient".
  • I searched for "fluoride is not an essential nutrient" among recent articles, and found only two sources, both quite unreliable. Widening the search to the last 20 years found no more such sources.
  • After further reading I'm inclined to think the following. First, the field of nutrition has to some extent (but certainly not completely) moved past debates about whether a nutrient is essential for survival, and toward more-complicated questions about whether a nutrient is needed for optimal health. Second, it'll take too much space to do this overall topic justice here, and any full details be in a different article. However, a brief summary would be helpful and I'll propose one in #Essential nutrient 2 below.
Eubulides (talk) 08:05, 6 September 2009 (UTC)

Essential nutrient 2

Here's a new version of the proposed material to be appended to Mechanism, updated in the list of the above discussion.

"Like dietary fiber, fluoride is a nutrient that acts against a harmful biological process; in fluoride's case the harm comes from a modern lifestyle involving sugar and oral microbes, and diets lower in sugar remove this need for fluoride.[1] It has not been proven unequivocally whether fluoride is an essential nutrient, in the sense of being required to sustain life or growth in humans.[2]"
References
  1. Jones PJ, Varady KA (2008). "Are functional foods redefining nutritional requirements?" (PDF). Appl Physiol Nutr Metab. 33 (1): 118–23. PMID 18347661.
  2. Olivares M, Uauy R (2005). "Essential nutrients in drinking water". Nutrients in Drinking Water. World Health Organization. pp. 41–60. ISBN 92-4-159398-9. {{cite book}}: |access-date= requires |url= (help); |format= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

Eubulides (talk) 08:05, 6 September 2009 (UTC)

Changed "prevents" to "acts against" as per discussion below. Eubulides (talk) 21:05, 9 September 2009 (UTC)
Looks good to me. Colin°Talk 00:03, 9 September 2009 (UTC)
Fluoride doesn't fit the standard definition of a nutrient. The undergrad textbook I mentioned, Understanding Nutrition by Whitney & Rolfes (10th edition, 2005) defines nutrients as "chemical substances obtained from food and used in the body to provide energy, structural materials, and regulating agents to support growth, maintenance, and repair of the body's tissues ..." - on the same page (p. 6) they discuss "nonnutrients" which includes "fibers, phytochemicals, pigments, additives, alcohols, and others". The textbook definition is the one which most people intuitively believe, and it is also used in other scientific contexts (eg, the algal bloom was caused by excess nutrients). It is the one used in the lead of Wikipedia's nutrient article ("A nutrient is a chemical that an organism needs to live and grow or a substance used in an organism's metabolism which must be taken in from its environment"). If one defines a nutrient as anything which prevents a harmful biological process, all preventive drugs would be nutrients. Even devices could be defined as nutrients. Latex could be a nutrient for promiscuous young men; "in latex's case the harm comes from a modern lifestyle involving sex and genital microbes; monogamy reduces the need due to reduced promiscuity" (ingestion is not necessary for nutrient status - note vitamin D). Caffeine is nutrient that prevents the "harm coming from a modern lifestyle involving little sleep", and statins are the nutrient which prevents the "harm coming from the modern lifestyle involving too many cheeseburgers". Anyway, I don't like it and I think it's illogical, but I don't have a source stating my position. Obviously there are a lot of people who call fluoride a nutrient, so I guess I won't oppose the above couple sentences.
I will see about finding out what the graduate level textbook [http://www.amazon.com/Advanced-Nutrition-Human-Metabolism-James/dp/0534555217 Advanced Nutrition and Human Metabolism] says about the topic. It's a better source than a speculative 2009 Current Opinion paper proposing that functional foods be defined as essential nutrients, based on the already controversial and problematic precedent of fluoride and fiber. II | (t - c) 06:52, 9 September 2009 (UTC)
Although I agree that there is controversy among reliable sources whether fluoride is an essential nutrient, I don't see the same controversy over whether fluoride is a nutrient. Here are two examples I found with a quick search for "fluoride nutrient" in PubMed:
  • "Food intake provides the necessary components for adequate metabolic functions in bone. Calcium, phosphorus, vitamin D, magnesium, proteins, and fluoride are some of the most important nutrients in this regard." —Vicente-Rodríguez et al. 2008 (PMID 18758899)
  • "The set of updated standards is now called Recommended Energy and Nutrient Intakes (RENIs), defined as levels of intakes of energy and nutrients ... The desirable proportions of protein, fats, carbohydrates as well as fiber are also provided, in addition to information on recommended intake levels for selenium, magnesium, manganese, fluoride, cobalamin, and vitamin K." —Barba & Cabrera 2008 (PMID 18460438)
These are not speculative papers. Certainly fluoride falls into the category of substances that are "regulating agents to support growth, maintenance, and repair of the body's tissues" (in this case, dental enamel in the presence of sugar and microbes). Eubulides (talk) 07:15, 9 September 2009 (UTC)
Perhaps this is an area where a language-change is occurring wrt to the word "nutrient". Driven by the experts but the rest of us haven't caught up. I share II's gut feeling that it isn't a "proper" nutrient like we learned when I was at school :-). Colin°Talk 19:36, 9 September 2009 (UTC)
No doubt it depends on which school you went to.... As this seems to be an argument about terminology rather than about the physical processes, how about if we make it clearer in the text that we are using the word "nutrient" in a particular sense? I modified the text as follows: "fluoride is a nutrient in the sense that it prevents a harmful biological process". I hope this helps to allay the concerns expressed above. Eubulides (talk) 19:52, 9 September 2009 (UTC)
No, don't do that. Do the sources say it is a "nutrient" but only in one sense? The article says fluoride repairs demineralisation with a tough veneer. That isn't just "prevents a harmful biological process" is it? If the expert consensus is that "nutrient" can be used wrt fluoride, without restriction/clarification, then we should be able to follow, even if some of our guts are unhapppy. Colin°Talk 20:12, 9 September 2009 (UTC)
The source (which is the first quote in #Essential nutrient above) says that there are two categories of essential nutrients, and that fluoride is a nutrient in the second category. This is what I tried (apparently unsuccessfully) to render with the phrase "in the sense of". I agree with your gut reaction about terminology shift; that was why I tried to make it clear in the text that we are using the word "nutrient" in the sense that the source uses it. For now, though, I've reverted that change to the draft. Perhaps, now that you've seen the source, you can suggest better wording (or maybe that wording was OK)? Eubulides (talk) 20:20, 9 September 2009 (UTC)
The source says "counters the deletrious action of an independent biological process". "counters" isn't the same as "prevents" as the former includes repair. I'm struggling to come up with a replacement word for "prevents", however I'm less worried about the current text than the "in the sense that" text because the latter made "prevention" the only reason it was called a "nutrient". Currently, "prevention" is just an example of how it is "nutritious". Colin°Talk 20:51, 9 September 2009 (UTC)
Thanks for catching both points. I changed "prevents" to "acts against"; that's a better synonym for "counters". Perhaps it's better to leave well enough alone about the "in the sense that" issue, as the following sentence makes it pretty clear that there is more than one nutrient category. Eubulides (talk) 21:05, 9 September 2009 (UTC)
As I mentioned, I'm not going to oppose the addition even though I don't agree with calling fluoride and fiber nutrients. So feel free to add it. II | (t - c) 22:57, 9 September 2009 (UTC)

EPA definition

The 2001 CDC description of what fluoridation is has been replaced by a 2006 definition by EPA. In the United States of America, EPA regulates fluoride in drinking water. Petergkeyes (talk) 11:55, 10 September 2009 (UTC)

I addressed this point in #More controversial edits recently installed below. The EPA's regulations are about water naturally fluoridated to levels far above those recommended for dental health, and have little to do with Water fluoridation. They should be (and are) discussed in Fluoride poisoning instead. Eubulides (talk) 15:56, 10 September 2009 (UTC)

More controversial edits recently installed

Another recent series of edits recently installed, again without discussion, removed several items of text that are well-supported by reliable sources:

  • "it [tooth decay] is expected to increase in several countries there due to changing diet and inadequate fluoride exposure" (supported by Petersen & Lennon 2004, PMID 15341615)
  • "the actual number [of people drinking naturally fluoridated water] is unknown and is likely to be much higher" (supported by "British Fluoridation Society et al. 2004")
  • "but sometimes the need for water fluoridation was met by alternative strategies" (supported by the same source)
  • It also substituted an enormously inferior source, cited only in the lead, to define water fluoridation. The CDC's definition (CDC 2001, PMID 11521913) is a consensus document written by a large committee of experts; the EPA glossary is a one-line definition in an unsigned random website. Please keep Wikipedia:Reliable sources (medicine-related articles) in mind when selecting sources for this article.

For now I reverted the change. One more time: please discuss possibly-controversial changes like this on the talk page first, before installing. Continuing to install controversial changes like this, without discussion, is counterproductive towards improving the encyclopedia. Eubulides (talk) 14:55, 10 September 2009 (UTC)

CDC definition is inferior because it comes from a biased source. CDC is a longtime promoter of water fluoridation, and its definition reflects its bias. EPA (notwithstanding its labor unions) does not take a position on fluoridation, therefore its dictionary-style definition is superior to CDC's. Also, the 2006 EPA definition is more up to date than the 2001 CDC promo. EPA's definition also clearly provides more information that CDC's, without the sentence being intrusively large.
No matter what the British Fluoridation Society, or Petersen and Lennon say, that does not make their statements encyclopedic. All three statements you reprinted with bullet points are POV, not facts. The first two don't even particularly say anything. They say, "we don't know, maybe this..." They are superfluous, they do not contribute to the article, and they should be re-removed. I explained each change on the history page. Please address my comments, rather than complaining that there has been, "no discussion." Petergkeyes (talk) 04:51, 11 September 2009 (UTC)
  • The CDC definition (CDC 2001, PMID 11521913) was written by the Fluoride Recommendations Work Group, a distinguished group of 11 dental experts, and was reviewed by 23 equally distinguished reviewers, all listed at the start of the report. It represents a consensus and peer-reviewed secondary source, which places it atop the list of reliable sources listed in Wikipedia:Reliable sources (medicine-related articles).
  • In contrast, the EPA source is an unsigned web page. Its definition of fluoridation is taken unchanged from page 24 of the 1997 EPA Terms of Environment (EPA 175-B-97-2001), which is an unsigned report that shows no signs of peer review. As the introduction to that 1997 document states, "The definitions do not constitute the Agency's official use of terms and phrases for regulatory purposes, and nothing in this document should be construed to alter or supplant any other federal document." So, not only is this source extremely weak by the standards of Wikipedia:Reliable sources (medicine-related articles), the source itself states that the definition has nothing to do with EPA's regulatory duties and should not be construed to alter or supplant the CDC's document.
  • "CDC definition is inferior because it comes from a biased source." The CDC position is obviously the mainstream position. WP:NPOV does not mean to omit all bias: it means to present all viewpoints in fair proportion to what they say, emphasizing the mainstream position. The EPA is not an expert on water fluoridation, and explicitly says that its definition of fluoridation is not authoritative; its glossary is a far inferior source.
  • "the 2006 EPA definition is more up to date than the 2001 CDC promo." No, as shown above, the EPA definition is from 1997, not that this is particularly relevant.
  • "EPA's definition also clearly provides more information that CDC's" The only difference in information is that the EPA's definition says "chemical", a word that fluoridation opponents prefer because (as Colin noted above) it scares people. It's easy to search through websites and find documents where "fluoridation" and "chemical" are close to each other. But that is not the best way to find reliable sources on the subject. The best way is to read the peer-reviewed literature, which is what the CDC definition is.
  • "All three statements you reprinted with bullet points are POV, not facts" All three statements are verified by reliable sources. They are all factual statements. There is no controversy among reliable sources about these matters. A Wikipedia editor's disagreement with reliable sources does not matter. What matters is what reliable sources say.
  • "The first two don't even particularly say anything." Sure they do. They contain valuable information about how changing dietary habits in less-industrialized countries, when combined with inadequate fluoride exposure, is expected to lead to increased tooth decay, and about the uncertainty of our knowledge of how many people drink naturally fluoridated water.
  • 'I explained each change on the history page. Please address my comments, rather than complaining that there has been, "no discussion."' I have addressed your comments. As for procedure: the top of this talk page makes clear that the procedure is to discuss potentially controversial changes to the article, and to gain consensus, before making the changes. Comments in edit summaries are not that kind of discussion.
In the light of the above comments I have reverted the changes. Please don't continue to attempt to make these changes without consensus, as continued efforts along these lines will hurt the encyclopedia.
Eubulides (talk) 06:12, 11 September 2009 (UTC)

Why not list exactly what it cost each year?

The article currently reads Typically a fluoridated compound is added to drinking water, a process that in the U.S. costs an average of about $0.92 per person-year. Over 300 million Americans, so does that mean we are spending hundreds of millions of dollars each year on it? When you look at how much money the government spends on other things, it usually shows a number, not that number divided by the number of people currently living in the country. Dream Focus 16:24, 10 September 2009 (UTC)

The cited source does not make this computation, and it would be original research for us to do the computation, so we can't include an overall figure here. Certainly it would be incorrect to multiply by 300 million, as only about 60% of the U.S. population receives artificially fluoridated water (2006 statistics). Similarly, it would be original research for us to compute the total sum saved by water fluoridation due to spending less money on dental treatments. Eubulides (talk) 17:40, 10 September 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)

Satire

This article needs a picture from Dr Strangelove. lol 58.167.41.154 (talk) 09:00, 12 October 2009 (UTC)

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)

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)

[citation needed] Shii (tock) 05:36, 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.
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)

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)
No further comment, so I moved it as suggested above. Eubulides (talk) 20:01, 16 October 2009 (UTC)
Thank you. —Preceding unsigned comment added by Gregwebs (talk • contribs) 02:44, 17 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)

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)

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)

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
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)

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 don't know what "discussions" are being referred to. The phrase "societal costs" does not appear in Water fluoridation. The cited source, Sheiham 2001 (PMID 11683551), gives the direct costs of caries treatment and cardiovascular disease, with the former being significantly greater. No reliable source disagreeing with this claim has been given in this thread. Eubulides (talk) 07:47, 16 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 previous comment incorrectly characterizes the edit in question. The edit didn't "reduce" the sentence: it inserted the sentence into the lead. The sentence does not summarize anything in the body (violating WP:LEAD) and is supported by a poor-quality source. The edit also inserted some phrases not supported by the cited sources. Eubulides (talk) 07:47, 16 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 introduction of "in an attempt" is an editorial comment that undermines what the cited source says. Let's stick with what the reliable source says. Eubulides (talk) 07:47, 16 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 cited source talks about defluoridation as "the lowering of the naturally occurring fluoride level in drinking water to prevent dental fluorosis". Water defluoridation is highly relevant to water fluoridation, as they have similar goals. Eubulides (talk) 07:47, 16 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)
The cited source does not use this sort of qualification ("Surveys conducted suggest") and neither should this article. The word "considered" suffices in the source to indicate the obvious point that the esthetic judgment is subjective, and that wording suffices in this article too. Eubulides (talk) 07:47, 16 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".
The cited source, Petersen et al. 2004 (PMID 15341615) does not say "substantial advantages over other fluoridation methods"; it merely says "substantial advantages". In the context of the cited source it's clear that it is talking about other fluoride methods; that same context is present here, as the text in question is following the discussion of other fluoride methods. There's no need to add "over other fluoridation methods" here, just as there is no need in the source. 07:47, 16 October 2009 (UTC)
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)
WP:3RR says "A series of consecutive saved revert edits by one user with no intervening edits by another user counts as one revert." I chose to revert those changes bit-by-bit rather than revert back to an earlier version of the article. That was because I wanted to review and discuss each edit rather than just say "it was all bad". BTW: I follow a one-revert-rule. Colin°Talk 08:13, 16 October 2009 (UTC)
(update) Hmm, I'd always understood WP:3RR as warring against one party (or group of editors) over an issue. But the policy page doesn't restrict the reverts in that way, so several IP/newbie editors come along and add different sorts of nonsense (such as this poison-nerve-agent theory), I'm limited after the first revert. Oh, well. I guess we need more eyes on this article. Colin°Talk 11:02, 16 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)
That sort of material would be original research in this article, and can't appear here. Eubulides (talk) 07:47, 16 October 2009 (UTC)
Wikipedia is an encyclopaedia, not a collection of bad-news stories. It is a very poor and unfair way of conducting an argument to list all the bad things one can find. Naturally, the press covers bad news. Nobody writes/reads news stories like "Wee Jonny went to the dentist for a checkup and didn't require any fillings." So such an article or set of articles would be perceived as a WP:POVFORK and foul WP:NPOV by seeking to cast a topic solely in a bad light. Colin°Talk 08:13, 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)
The cited source, Burt & Tomar 2007 (ISBN 0195150694), is high-quality expert opinion, and the opinion is properly qualified with a "may be" here. The sentence in question is extremely helpful in the lead, as it ties together the previous sentences' coverages of alternative fluoride methods and of different experiences in U.S. and Europe. No reliable sources disagree with the claim in question. Eubulides (talk) 07:47, 16 October 2009 (UTC)

Weapons grade uranium etc.

A recent edit by the new user Roger Masters (talk · contribs), whose user name suggests that of the antifluoridation activist Roger Masters, inserted a large quantity of material that was original research, had serious WP:WEIGHT issues, and promoted WP:FRINGE theories (e.g., "waste products from processing weapons grade uranium"). I reverted the edit. Normally I would copy the material in question to the talk page for further discussion, but this insertion is fairly long and appears to contain copyrighted material that is reproduced without permission, so I'm not going to do that here. The main issue that the inserted material discussed, namely the safety of silicofluorides, is already covered in the 4th paragraph Water fluoridation #Safety, citing sources that are far more reliable than what was in the inserted text. Eubulides (talk) 07:47, 16 October 2009 (UTC)

Yiamouyiannis and other low-quality sources

A recent edit inserted the following text:

"Even though it it widely endorsed, various scientific studies have found fluoridation to have a detrimental effect or no effect at best."

citing the following sources:

  • Yiamouyiannis, J (1990). "Water Fluoridation and Tooth Decay: Results From the 1986-1987 National Survey of U.S. Schoolchildren". Journal of The International Society for Fluoride Research. 23 (2): 55–67.
  • Ziegelbecker RC, Ziegelbecker R (1993). "WHO data on dental caries and natural water fluoride levels". Fluoride. 26: 263–266.
  • Diesendorf M (1986). "The mystery of declining tooth decay". Nature. 322: 125–129.

These sources do not support the claim in question: they do not say "Even though it it widely endorsed, various scientific studies have found". The claim in question is therefore original research. Furthemore, the first two sources are WP:FRINGE sources. For example, Yiamouyiannis was a notorious laetrile and fluoridation activist, and his work is discreded; see, for example, Horowitz 2000 (PMID 10929563), who writes

"Yiamouyiannis has repeatedly obtained data from government sources and then analyzed them to show damaging effects from community water fluoridation. His spurious analysis–based on crude mortality data unadjusted for age, sex, or race, showing that persons in fluoridated communities die from cancer more than do persons in non-fluoridated communities–has been fully discredited by the National Cancer Institute of NIH."

Ziegelbecker & Ziegelbecker 1993 has similar problems: it is also fringe. The third source, Diesendorf 1986, was a reasonable source in the middle 1980s when it was published, but its point is that dental caries has been reduced even in areas that do not practice water fluoridation, which is quite a different matter (and one that is already covered by the lead, with much better and more-recent reviews). Even if the first two sources were reliable, which they are not, they are primary sources, and as per Wikipedia policy and guidelines they should not be used to attack or undermine reliable secondary sources. The third source is far too old and does not support the claim in question. Please see WP:PSTS and WP:MEDRS for the Wikipedia policy and guidelines that are clearly violated by this insertion. For now, I've reverted the change. I suggest that further discussion on this topic be done on this talk page first, before attempting to make obviously-contradictory changes like this. Eubulides (talk) 16:36, 16 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:

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.

Perhaps it would be helpful if you could indicate which part(s) of the sentence you have problems with?
  • 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)
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)
This is directly supported by citations in the article "Community water fluoridation and caries prevention: a critical review" PubMed 17333303: "...the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread... studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention particularly in the industrialized countries where the caries level has became low."
This major point about the effectiveness of water fluoridation should be in the introductory statements to maintain accuracy and a NPOV. —Preceding unsigned comment added by Gregwebs (talk • contribs) 03:55, 17 October 2009 (UTC)
"This is directly supported by citations in the article" No, those quotes from Pizzo et al. 2007 (PMID 17333303) do not establish that water fluoridation does not reduce tooth decay in those who brush with fluoride toothpaste regularly. On the contrary, they say that water fluoridation has less of an effect (not "no effect") on regular tooth-brushers, and that in an industrialized society willing to tolerate a somewhat-higher level of caries than would obtain with water fluoridation + fluoride toothpaste (perhaps because dental treatments are free or low-cost) the water fluoridation may be unnecessary. The implication is that, in a society where dental treatments are unavailable or are too expensive for the poor, society might not be willing to tolerate this somewhat-higher level of caries, and water fluoridation would then still be necessary. This point is currently made in the lead in the last sentence of the 2nd paragraph, citing Burt & Tomar 2007. The opinion of Pizzo et al. 2007 is already featured quite prominently in the lead compared to the weight given their arguments by other reliable sources; there would be a WP:WEIGHT problem in featuring them much more than they're already featured. But perhaps, if you think this part of their argument is crucial, it could replace some of the existing text. Eubulides (talk) 06:27, 17 October 2009 (UTC)
I do think for this section titled "effectiveness" the fact that the effectiveness greatly varies if there are other methods of fluoride exposure needs to be clearly stated and reflected in the introductory remarks. —Preceding unsigned comment added by Gregwebs (talk • contribs) 20:16, 17 October 2009 (UTC)
The Effectiveness section already does what you're requesting. Its second sentence says the effectiveness of water fluoridation has gone down significantly with time, likely due to the introduction of fluoride toothpaste, plus the halo effect. Eubulides (talk) 07:37, 19 October 2009 (UTC)
Ok, I was in the mindframe of only thinking about an intro sentence, not an intro paragraph. If we remove the first sentence that doesn't add useful information, then we will have a good intro paragraph that goes over the historical effectiveness of water fluoridation and makes very specific statements with useful information. Gregwebs (talk) 23:52, 19 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)
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)
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"[3]). 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)
"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)
"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 a modern high sugar diet fluoride acts as a nutrient against tooth decay and could be considered an essential nutrient."
If something is being proposed as a potential nutrient, then that means it is not considered to *be* an essential nutrient, and the text needs to reflect this fact, instead of implying through weasel words that fluoride is an essential nutrient. The statement about fiber also should be removed until it can be reworded or cited- as it stands the "harmful biological process" it acts against is unknown. Gregwebs (talk) 03:12, 17 October 2009 (UTC)
Please see #Essential nutrient 2 below. Eubulides (talk) 06:27, 17 October 2009 (UTC)

Essential nutrient 2

  • "If something is being proposed as a potential nutrient" But that's not what's happening. The cited source (Jones & Varady 2008, PMID 18347661) doesn't say that it is proposing that fluoride is an essential nutrient: it is saying that fluoride is an essential nutrient, using the more-modern definition of essential nutrient. The article's proposal is not about fluoride at all: it is a proposal that plant sterols and omega-3 fatty acids should be considered to be essential nutrients in this more-modern sense.
  • "instead of implying through weasel words that fluoride is an essential nutrient" The current text does not imply that fluoride is an essential nutrient. It says only that we don't have conclusive proof that it is essential (in the traditional sense of "essential"). There is some evidence that fluoride is essential (in the traditional sense), but the evidence is too weak to draw such a conclusion unequivocally.
  • "The statement about fiber also should be removed until it can be reworded or cited" The statement is cited. It's sourced to Jones & Varady 2008, who compare fluoride to "dietary fiber in its capacity to slow or restrict glucose and bile acid absorption."
  • "in the a modern high sugar diet fluoride acts as a nutrient against tooth decay" This isn't quite right; as Jones & Varady write, the modern lifestyle involves both sugar and oral microbes, and it would suffice to remove either. It may become practical to vaccinate against the microbes, for example.
  • 'as it stands the "harmful biological process" it acts against is unknown' I don't see the need for this article to go into the details about dietary fiber's action against glucose and bile acid absorption. The point is that fluoride is not alone in being a nutrient that works in a negative way, and mentioning dietary fiber suffices to make that point. Anybody curious about the details can click on the wikilink to Dietary fiber.

Eubulides (talk) 06:27, 17 October 2009 (UTC)

Part of the problem is clicking on the link to the dietary fiber page doesn't give the details as to what the harmful process is. On that page, and in popular knowledge, fiber does not so much "act against a harmful biological process", but instead it is supposed to provide various benefits. The claims for fiber are varied, whereas the claim for fluoride is it helps one specific biological pathway. If instead it stated "like fiber, fluoride is only beneficial under certain dietary circumstances", that would be more to the point.
as per microbes, I thought the logic for stopping cavities is an OR, not an AND- eliminating either one of the two stops cavities (but I assume the practical idea is to somehow reduce microbes to reduce cavities, not elimination) —Preceding unsigned comment added by Gregwebs (talk • contribs) 20:52, 17 October 2009 (UTC)
  • 'On that page, and in popular knowledge, fiber does not so much "act against a harmful biological process", but instead it is supposed to provide various benefits.' Many of those benefits accrue not because fiber is an essential nutrient in the traditional sense: they accrue because fiber interferes with other processes. I've added a new section Dietary fiber #Mechanism to try to cover this issue better.
  • "I thought the logic for stopping cavities is an OR, not an AND" Yes, that's right. The point is that the text should mention both arms of the OR. And you are correct that the vaccines would not eliminate all microbes, just as dietary intervention would not eliminate all sugar.
  • "like fiber, fluoride is only beneficial under certain dietary circumstances" That wouldn't be quite right, as dietary fiber is beneficial pretty much everywhere, whereas fluoride isn't needed in locations where people practice low-sugar (and low-starch) diets.
Eubulides (talk) 07:37, 19 October 2009 (UTC)
The point still remains that the claims for fiber are varied and complex (not to mention made with weak evidence), which means this comparison can introduce confusion instead of clarity, particularly if there are no specifics with fiber.
There are well-documented examples of cultures that have had great teeth and great health and no need for fluoride or fiber (Eskimos are the first that come to mind). So to the best of scientific knowledge, flouride and fiber are only useful under certain dietary circumstances, and have never been shown to be useful for everyone, everywhere. But while the statement I made was accurate, you and others will still read it with confusion about its accuracy, which is why this article would be better off without the fiber reference.
Gregwebs (talk) 19:00, 19 October 2009 (UTC)
You are correct about fluoride (and that point is made in the Water fluoridation article), but incorrect about dietary fiber. Although the traditional Eskimo diet was significantly lower in dietary fiber than (say) the traditional western European diet, it did contain dietary fiber derived from animals (nondigestible aminopolysaccharides). I don't know of any human diet that was essentially fiber-free. Furthermore the "great health" of the traditional Inuit was actually not that good by modern standards, and although of course there are no reliable health statistics for the Inuit before European contact, more-recent statistics include higher rates of some diseases, such as gallbladder cancer, that are associated with low-fiber diets. Anyway, we are starting to diverge from the subject of this talk page. I'm a bit lost about which statement is meant by "the statement I made was accurate", so I can't follow the last sentence in the previous comment. Eubulides (talk) 20:45, 19 October 2009 (UTC)
Do you have any more information about dietary fiber from animals? I am interested in this information, and it should be added to the dietary fiber page when you have time. The only information I can find is that connective tissue could be considered fiber. Recent studies of the Inuit also show diabetes and alcoholism, and are quite useless for determining pre-contact health. The only information I have come across so far (observational or archeological) seems to show good health, including an absence of dental caries.
We digress. But the above points that there are multiple claimed mechanisms of fiber for different processes in the body, with varying degrees of effectiveness that are generally based on low quality research means that making a non-specific comparison to dietary fiber is a source of confusion and should be removed. —Preceding unsigned comment added by Gregwebs (talk • contribs) 23:37, 19 October 2009 (UTC)

Why was this edit done?

Why was this edit (which removed the "Like dietary fiber" clause) done? What I see above is an original-research discussion on whether the analogy is appropriate. That's fine to a degree but since it appears to have reached a stalemate, the casting vote should really go to our sources, which use the analogy. Or have I've missed something, and Eubulides has conceded the analogy is not appropriate? I think the analogy has some merit but like all analogies, can be shown to be not exactly 1:1. Colin°Talk 08:34, 26 October 2009 (UTC)

AFAIK Eubulides has not conceded, but he has stopped discussing. I propose to removing the reference to fiber until it is defended. The issue is less one of original-research and more one of: is the analogy appropriate considering the complex multiple mechanisms by which fiber is explained to work, and the lack of explanation following the wiki link. What sources are using a direct analogy? This article explains the specific biological pathway and condition that can be improved for flouride. If the fiber reference is maintained, I think it should make a specific statement about either a biological pathway or a condition it can improve. —Preceding unsigned comment added by Gregwebs (talk • contribs) 14:25, 26 October 2009 (UTC)
That would be OK; I inserted something along the lines of this suggestion. Eubulides (talk) 15:48, 26 October 2009 (UTC)
The source doesn't just say "slow bile acid absorption" it says "slow or restrict glucose and bile acid absorption". I'm absolutely no expert here but the dietary fiber article particularly mentions the reduction in bile acid absorption rather than slowing (the reduction lowers cholesterol levels in the blood, apparently). The slowing seems more applicable to the glucose absorption, which smooths out variance in blood glucose levels. Why don't we just keep the whole phrase? Colin°Talk 16:56, 26 October 2009 (UTC)
I'm no expert either, but when it comes to the gut my impression is that there's not a sharp line between slowing and restricting. That being said, it's OK to mention both, and to mention glucose too, so I added that as well. I hope it's OK that my change substituted the plainer-language but less-precise "sugar" for the scientific "glucose". Looking back on my change now, this material is starting to become a digression, and I wouldn't object if it got trimmed back to something shorter. Do we really need to mention both bile acid and glucose? Surely one's enough here. Eubulides (talk) 17:08, 26 October 2009 (UTC)
I like the changes. Probably only 1 mechanism is necessary for comparison purposes. Note that "the harmful biological process" has still not been stated for fiber. The grammar seems incorrect. "Just as dietary fiber can slow sugar absorption to act against the harmful process of (insulin spikes?) ..." Gregwebs (talk) 17:27, 26 October 2009 (UTC)
I interpret "restriction" as actually limiting or reducing the amount absorbed whereas "slowing" may not limit or reduce the amount at all. If we want to just mention one, the problem might be picking the appropriate combination. This is the problem I had with "slow bile acid absoption" in that I think the wrong combination was picked. I'm not sure we can give details of the benefit of either of these effects without including another source. I think the current text is fine and doesn't need to be shortened or give more detail on any one of the effects. Colin°Talk 17:47, 26 October 2009 (UTC)
Really, to bring the analogy full circle we need something like this: "Just as dietary fiber can act as a nutrient to aid in slowing the digestion of sugar, fluoride can act as a nutrient in a diet high in sugar to prevent tooth decay. A diet low in sugar removes the need for fluoride." Gregwebs (talk) 20:03, 26 October 2009 (UTC)
Where does the "high in sugar" == needed / "low in sugar" not needed rule come from? And the reader is going to think the connection is "sugar" and not "sort of a nutrient". Colin°Talk 22:38, 26 October 2009 (UTC)
The point that needs to be made is that both are conditionally essential. If we can't come up with a good way to state that fiber is conditionally essential, then it should be removed altogether. Gregwebs (talk) 17:23, 27 October 2009 (UTC)
Please see #Conditionally essential below. Eubulides (talk) 17:45, 27 October 2009 (UTC)

Conditionally essential

"The point that needs to be made is that both are conditionally essential." No, the cited source doesn't say that. The source (Jones & Varady 2008, PMID 18347661) likens dietary fiber to fluoride not on the grounds of conditional essentiality, but on the grounds that both are counter-permissive nutrients, i.e., both have beneficial nutritional effects that occur because they counter an adverse action of some other biological process. The current text in Water fluoridation captures this, in that it says that fluoride is like dietary fiber in that it "acts against a harmful biological process". The text goes on to say that fluoride's benefit is conditional, but it (correctly) does not claim that the same thing is true for dietary fiber. Eubulides (talk) 17:45, 27 October 2009 (UTC)

Ok, but the "harmful biological process" that fiber acts against is still not stated. —Preceding unsigned comment added by Gregwebs (talk • contribs) 00:59, 29 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)

Fluoride toothpaste is widely used

A recent deletion by 71.235.238.78 (talk · contribs · WHOIS) (which has been reverted twice, and then reinstated twice by the same IP address) removed the sentence, talking about fluoride toothpaste, that "It is widely used, but less so among the underprivileged.". with edit summaries like "again, that part of the sentence sounded like it was advertising fluoride toothpaste, or in some way promoting its use".

The cited source, Jones et al. 2005 (PMID 16211158), directly supports the sentence. The source says "Probably the most widespread and significant vehicle used for fluoride has been toothpastes.... Uptake and use has not been uniform and is less likely among underprivileged groups." This is not an advertisement: it is a public-health paper published in the Bulletin of the World Health Organization, with a wide variety of dental and public-health coauthors. Because the sentence is well-sourced and relevant, I've restored it. I suggest to the IP address to please discuss the matter here rather than continuing to remove the material against consensus. Eubulides (talk) 03:31, 31 October 2009 (UTC)

Mainly because

A recent edit added the text:

"mainly because addition of fluoride does not improve the safety of drinking water as such (legal reason) and because of the availability of alternatives."

However, the cited source, Martin 1989 (doi:10.1111/j.1533-8525.1989.tb01511.x), does not support this newly added text. That source does not come to any conclusions about the main reasons for the administrative decisions in Europe. The source gives just one example, in Denmark, and this example does not talk about improving the safety of drinking water, or about legal reasons, or about the availability of alternatives. As the change is not at all supported, I have reverted it for now. Eubulides (talk) 19:41, 4 November 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)
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)
Have you read WP:FRINGE?. Almost all of the mainstream pro-fluoride review articles acknowledges the opposition arguments. That alone is enough to show it is not fringe. —Preceding unsigned comment added by Gregwebs (talk • contribs) 15:45, 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)

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)
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)

It's hard to follow this entire discussion

It's hard to follow this entire discussion, but I'd like to note briefly that I've noticed the same thing as the original poster. The section on "safety" uses several paragraphs to present water fluoridation as essentially safe, containing only a small link named "several long-term adverse effects" detailing possible adverse effects of excessive fluoride intake. Meanwhile, arguments against fluoridation are relegated to the section "Ethics and politics", which presents the issue as a complete fiction without any basis in fact, with no attempt being made to examine what specific claims are being made or what documentation may be available to support those claims. It's one thing to take controversial claims with a grain of salt, but to maintain an article so biased that it reads like a pro-fluoridation activism site is a bit much.

(On a related note, the section also links to an additional article, Opposition to water fluoridation, whose "Potential health risks" section simply links back to the previous section again in a circular manner, with neither containing much information on the topic.)

On the other hand, some anti-fluoridationists go to great lengths to document their claims with references to scientific literature, for instance the so called "Fluoride Action Network": [.org/health/biblio.html HEALTH EFFECTS: Bibliography of Papers Cited by FAN] [.org/iq.studies.html 23 published studies report an association of reduced IQ with high fluoride exposure]. If Wikipedia continues to misrepresent the issue as nonexistent, anyone able to Google their way to one of these pages will have to doubt Wikipedia's credibility as a source.

Rōnin (talk) 15:27, 12 November 2009 (UTC)

  • "arguments against fluoridation are relegated to the section "Ethics and politics"" No, they're presented in many sections. For example, the lead section talks about dental fluorosis, about other adverse effects, about the low quality of safety studies, about the fact that European countries seem to be doing just fine without water fluoridation, about the conflict between individual rights and the common good, about the controversy, and about ethical, legal, safety, and effectiveness arguments against fluoridation. Each of these comments in the lead section are followed up in multiple sections in the body. For example, the Implementation section says that the U.S. standard for fluoridation has become obsolete; the Mechanism section says that it's not known whether fluoride is an essential nutrient; the Evidence basis says that there's consistent evidence that fluoridation causes dental fluorosis and that research into most potential adverse effects has been almost all of low quality; the Alternatives section says that toothpaste is more widely used and more rigorously evaluated; the Economics section says there's little high-quality research on cost-effectiveness and that fluoridation harms the income of dentists; the Use around the world section that many communities have discontinued fluoridation, due not only to political opposition but also by alternative strategies; and the History section says that pioneering studies of fluoride were crude and gives more examples of discontinuance of fluoridation. This is just a summary of some of the arguments against fluoridation presented in these sections: I have not enumerated them all.
  • "the section "Ethics and politics", which presents the issue as a complete fiction without any basis in fact" The Ethics and politics section focuses on ethics and politics; by design, the science and medicine topics are discussed in Evidence basis and it would be repetition to re-discuss them in Ethics and politics. The same holds for pro-fluoridation arguments, of course: the science behind them is not discussed in Ethics and politics, because it's already covered in Evidence basis.
  • "to maintain an article so biased that it reads like a pro-fluoridation activism site is a bit much." From the point of view of an anti-fluoridationist, this article no doubt appears to be pro-fluoridation. Similarly, pro-fluoridationists probably view this article as being anti-fluoridation, because it gives so much space to anti-fluoridation sources. For example, the two most-commonly cited sources in this article are Pizzo et al. 2007 (PMID 17333303), which is anti-fluoridation, and NHMRC 2007, which is pro-fluoridation. You would never see that in pro-fluoridation website. Instead, you'd see language like "Fluoridation is the perfect public health intervention."[4] That's not language that you see here. (Of course, you'd never see all those citations to a pro-fluoridation review in an anti-fluoridationist summary either.)
  • "the section also links to an additional article, Opposition to water fluoridation, whose "Potential health risks" section simply links back to the previous section again in a circular manner" That is a problem, but it's really a problem with Opposition to water fluoridation (a much lower-quality article), and should be fixed there.
  • "the so called "Fluoride Action Network" The Fluoride Action Network is a partisan source that does not follow established scientific principles of peer review. As a questionable source it cannot be used in Wikipedia articles to support claims about fluoridation. We need reliable sources to support such claims. Please see Wikipedia:Reliable sources (medicine-related articles) for guidelines on reliable sources on medical topics.

Eubulides (talk) 21:07, 12 November 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 —Preceding unsigned comment added by Bitcloud1 (talk • contribs) 12:38, 15 October 2009 (UTC)

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)

Thanks for those sources. They are more recent than Sheiham 2001 (PMID 11683551), the source we had cited as saying that dental caries was #1. I found another WHO source, Petersen 2008 (PMID 18630105) which the article is already citing, agreeing with the "fourth most expensive" claim. Looking further, I even found a 2005 editorial by Sheiham (PMID 16211151) agreeing with the "fourth most expensive", so it appears that the claim about being #1 is dated at best. I switched to saying it's #4, citing the 2008 WHO source. Sorry about taking so long to look into this: I lost this thread in the main-page flurry of comments. Eubulides (talk) 08:39, 7 November 2009 (UTC)

Hoge Raad der Nederlanden

A recent edit reinserted material about a 1973 decision by the Hoge Raad der Nederlanden. This level of detail is inappropriate for Water fluoridation. There must be hundreds of court decisions all over the world about fluoridation, and there's no particular reason to emphasize this one here. When similar material was added earlier, it was promptly and properly moved to Fluoridation by country #Netherlands; that is a much better place for that sort of detail. Please don't continue to reinsert this material without proper discussion and consensus. Eubulides (talk) 21:23, 4 November 2009 (UTC)

I reverted my edit on The High Council of The Netherlands in The Netherlands forbid fluoridation since addition of fluoride does not improve the safety of drinking water as such and water suppliers go beyond their legal task as requested by Eubulides on my talk. In my opinion my contribution is important because the present section on Ethics and politics seem to me a little unbalanced towards Anglo-Saxon countries. This is most probably due to the fact that in continental Europe there is almost no discussion on water fluoridation. The section just addresses Europe in half a sentence. However, Europe exists of many countries, all with there own approach. Martin states that most public administrations in continental Europe has taken the decision not to fluoridise, however, without giving a reference. This means not all of them used governmental decisions. In my opinion it is informative to mention in this section more background why there is little discussion in continental Europe. This is not addressed in this section. My contribution, although maybe not perfect, was a first try.
Eubulides states that we should use reliable reviews of the topic, rather than citing court decisions directly. The article currently cites several reviews of water fluoridation (including negative opinion) and as far as I know none of these reviews mention this 1973 court case. As per WP:WEIGHT, we can't assign far more weight to this subtopic than reliable sources do, nor should we be citing primary sources directly when we have substantial secondary sources available Although I agree that reviews should have preference over specific papers, the references on water fluoridation are mainly primary sources and even some gray literature. That the Dutch Supreme Court case is not mentioned in reviews may have several reasons. First, the Dutch language is not well accessible for non-speakers and second, court cases in general are not easy to access. This problem is also valid for other European languages. So my conclusion is that due to the absence of substantial secondary sources, primary sources can be used. However, what disturbed me most is the fact that Eubulides’ statement implicitly marginalises the reference I used as unreliable.
In order to balance the section on ethics and politics I propose elements of the following text. Martin gives three main grounds for against fluoridation. First, opponents claim the benefits are exaggerated or not established. Second, there are claims of health risks to some members of the population; the Danish government seems to have followed this line. Third, fluoridation is thought to be an infringement on individual rights because it is compulsory medication of all members of a community, as opposed to chlorination, which is treatment of the water. This line was more or less followed by the High Council of The Netherlands that forbid fluoridation based on the judgement that addition of fluoride does not improve the safety of drinking water as such and water suppliers go beyond their legal task. The prohibition of fluoridation by the High Council due to the lack of a legal basis stopped the whole discussion in The Netherlands in 1973 (see also nl:drinkwater#Het drinkwaterfluorideringsdebat). Sweden followed similar route as The Netherlands.
E.J.Hoekstra (talk) 23:39, 6 November 2009 (UTC)
Thanks for your thoughtful comments. Please see #European views below. Eubulides (talk) 06:32, 7 November 2009 (UTC)

European views

  • "in continental Europe there is almost no discussion on water fluoridation" I expect there's not that much discussion anywhere. Most people have more-important things to worry about. I agree that the topic comes up even more rarely in Europe, because water fluoridation is more-rarely practiced there.
  • "it is informative to mention in this section more background why there is little discussion in continental Europe" But we'd need a reliable source to make that point, no? I.e., we'd need a source making the point that there is little discussion in continental Europe because fluoridation is rarely practiced there. Although that point is probably true, we can't make it without a good source.
  • "The section just addresses Europe in half a sentence." Not true. The Ethics and politics section specifically mentions the European Academy of Paediatric Dentistry, a German chemical company, the Green party in the UK, a 2003 study of focus groups from 16 European countries, and a 1999 survey in Sheffield, UK, in addition to the administrative decisions you noted. Also, that section cites European sources heavily. It cites:
That's ten citations to European sources, compared to (by my count) 13 citations to U.S. sources and 9 citations to sources that are neither U.S. nor European. There is certainly no bias against European views here; on the contrary, given the relatively small amount of literature on the subject generated in Europe, one could argue that there's a slight bias for European sources.
  • "due to the absence of substantial secondary sources, primary sources can be used" But there is no such absence. As I mentioned in the previous bullet, that section already cites 10 European sources. Other sections cite many European sources as well. These are by and large secondary sources, which is better for Wikipedia.
  • "Europe exists of many countries, all with there own approach" Yes, and it's beyond the scope of this article to discuss each country's approach: we need to draw a relatively-broad brush here, just as the coverage of North America does not discuss individual U.S. states or Canadian provinces (which have very different practices). That sort of detail is appropriate for Fluoridation by country, but is far too much detail for the more-general article.
  • "the references on water fluoridation are mainly primary sources and even some gray literature" The references on almost any topic are mainly primary sources and/or gray literature. But Wikipedia articles should avoid these references: it should use reliable reviews (see WP:PSTS and WP:MEDRS). Water fluoridation relies mostly on secondary sources for its conclusions, and there's no reason to lower its standards on this particular point.
  • "That the Dutch Supreme Court case is not mentioned in reviews may have several reasons." Yes, and in addition to the reasons given, it may not be mentioned because it's dated and limited in scope. There have been many court decisions all over the world about water fluoridation, and they're all based on legal principles and arguments about safety, rights, the law, etc. The text of the Dutch decision itself does not provide any evidence that the decision is still important enough to mention here.
  • "In order to balance the section on ethics and politics" That section already gives a bit more space to opponents of fluoridation than it does to proponents. Giving even more weight to opponents would present obvious WP:WEIGHT issues. This is not to say that we can't change the section, but the section is already overlong, and any additions should be balanced with deletions (which can be moved into the see-also article).
  • "Martin gives three main grounds for against fluoridation." Yes, and those three grounds are already covered in Ethics and politics:
  • "First, opponents claim the benefits are exaggerated or not established." The article text currently says "Since fluoridation's inception, proponents have argued for scientific optimism and faith in experts, while opponents have drawn on distrust of experts and unease about medicine and science. Controversies include disputes over fluoridation's benefits and the strength of the evidence basis for these benefits,"
  • "Second, there are claims of health risks to some members of the population" The article text currently talks about "the difficulty of identifying harms" and goes not to say, "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."
  • "Third, fluoridation is thought to be an infringement on individual rights because it is compulsory medication of all members of a community, as opposed to chlorination, which is treatment of the water." The article text currently says "Fluoridation can be viewed as a violation of ethical or legal rules that prohibit medical treatment without medical supervision or informed consent, and that prohibit administration of unlicensed medical substances." and later, discusses "legal issues over whether water fluoridation is a medicine, and the ethics of mass intervention."

Perhaps the abovementioned wording could be improved without making it longer and causing weight problems: do you have specific suggestions? Eubulides (talk) 06:32, 7 November 2009 (UTC)

  1. ^ Cite error: The named reference Ripa was invoked but never defined (see the help page).
Retrieved from "https://wiki.riteme.site/w/index.php?title=Talk:Water_fluoridation/Archive_4&oldid=1276832444"