Talk:Water fluoridation/Archive 10

Israel Ceases Water Fluoridation - Is that Fringe?
Hardly, as a well educated industrialized nation the practice will be discontinued as pressure was brought to bear by a vocal (fringe?) citizen group led by Yaacov Gurman. A dramatic $4 billion dollar lawsuit was petitioned to their highest court. A new health minister was brought in and the court cited the cessation in reply to the petitioner. This is quite relevant as it is recent and reflects change taking place by an entire nation that is not considered radical or fringe.

The landscape of this topic changing.. lets show the current facts as they are today... not merely decades past. https://en.wikipedia.org/w/index.php?title=Water_fluoridation&diff=601624283&oldid=601390742 This is quite relevant and was reverted wholesale by doing a complete reversion. — Preceding unsigned comment added by WikiShares (talk • contribs) 14:38, 28 March 2014‎
 * The complete reversion was over a lot of issues. Anyone who does not want their content reverted completely should be conscious of not putting a copyediting burden on others by dividing their edits. Persons wanting points considered individually should make them individually. There are a lot of changes in this revision which have nothing to do with the issue described.  Blue Rasberry   (talk)  14:43, 28 March 2014 (UTC)


 * As a technical note, you may want to re-read the link to WP:DIFF I provided above. The diff that you've provided here covers 17 edits by six different editors; it's not clear which changes are yours, or what edits you're trying to discuss.  To produce a diff of a single edit, go to the article's history page, and look at the address of (or click on) the link labelled "prev" next to a particular edit.   That generates a diff (the difference) showing the changes made in that edit.  If you instead click on "curr", it gives you a link showing the difference between that revision and the current version of the page (and may span dozens or hundreds of edits.)  TenOfAllTrades(talk) 14:57, 28 March 2014 (UTC)

Lets be very clear. Israel did not "ban" fluoriation, it rescinded national regulations requiring local governments to ensure fluoridation, and it did so over the strong objections of national medical societies. The end result of thi will be a small number of municipalities in a small country changing their policy. Any attempt to use a decision by a small fraction of 1% to change their fluoridation policy as evidence of an incipient shift in scientific concensus would clearly be premature and misleading. Formerly 98 (talk) 16:12, 28 March 2014 (UTC)
 * The laws do not change for a few more months in Israel do they? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:45, 28 March 2014 (UTC)


 * The problem is that antifluoridationists are (as they always do) conflating politics and science. Even if Israel banned fluoridation outright (which it hasn't), it would make precisely no difference at all to the scientific consensus that fluoridation is a safe and effective public health intervention. It's equivalent to the Indiana Pi Bill. Guy (Help!) 13:10, 29 March 2014 (UTC)

EU 2010 SCHER water fluoridation report. Not represented in the article???
I find it quite incredible that even 1 citation or even a miserly mention of the most comprehensive and updated (2010) review of water fluoridation from the European Commission - Is not in this article.

I searched the talkpage archive, and about 10 months ago, another editor raised the question and also went into specifics: https://en.wikipedia.org/wiki/Talk:Water_fluoridation/Archive_8#facts.2C_sources.2C_NPOV_...

The single response he got was basically "i don't know what this report is.." and then was completely ignored.

So I' m going to revive that thread and copy-paste it's relevant stuff.

I'll start with an answer to that question: What is the SCHER report ? "To obtain an up to date scientific view on the matter [fluoridation of drinking water] the European Commission asked the Scientific Committee on Health and Environmental Risks (SCHER) to elaborate an opinion on the safety of fluoride" http://ec.europa.eu/health/publications/docs/achievements2010_en.pdf (page 30)

And some of my additions (quotes from the report) :


 * “Fluoride is not an essential element for human growth and development…”


 * “Systemic exposure to fluoride through drinking water is associated with an increased risk of dental and bone fluorosis in a dose-response manner without a detectable threshold.”


 * “Scientific evidence for the protective effect of topical fluoride application is strong, while the respective data for systemic application via drinking water are less convincing. No obvious advantage appears in favor of water fluoridation as compared with topical application of fluoride.”


 * “For younger children (1-6 years of age) the UL (The upper tolerable intake level) was exceeded when consuming more than 1 L of water at 0.8 mg fluoride/L (mandatory fluoridation level in Ireland) and assuming the worst case scenario for other sources. For infants up to 6 months old receiving infant formula, if the water fluoride level is higher than 0.8 mg/L, the intake of fluoride exceeds 0.1 mg/kg/day, and this level is 100 times higher than the level found in breast milk (less than 0.001 mg/kg/day).”

Quoted from older thread:

The article seems to overstate the benefits of water fluoridation (compared to alternatives), misrepresent the situation in Europe, does a fine job avoiding neutral sources. First non-wiki result when I google water fluoridation europe is Questions on water fluoridation - European Commission - Europa but SCHER or publications by the European commission aren't used as source anywhere in the article.

In it's 2010 report to the European Commission, the conclusions of the Scientific Committee on Health and Environmental Risks' include:
 * The benefits of preventive systemic supplementations (salt or milk fluoridation) are not proven.
 * The efficacy of population-based policies, e.g. drinking water, milk or salt fluoridation, as regards the reduction of oral-health social disparities, remains insufficiently substantiated.
 * No obvious advantage appears in favor of water fluoridation compared with topical prevention. The effect of continued systemic exposure of fluoride from whatever source is questionable once the permanent teeth have erupted.
 * SCHER agrees that topical application of fluoride is most effective in preventing tooth decay. Topical fluoride sustains the fluoride levels in the oral cavity and helps to prevent caries, with reduced systemic availability.

About the studies regarding salt fluoridation in Jamaica, SCHER finds:
 * These studies are all considered of simplistic methodological quality.

The ethics and politics section doesn't mention that information gaps regarding fluoride “prevented the committee from making some judgments about the safety or the risks of fluoride at concentrations of 2 to 4 mg/L., and that water systems could supply up to 4mg/L for a year before informing the customers. Instead we get the crazy theories of some opponents. Other articles (like 9/11) don't need a list of all the conspiracy theories to strengthen the official version by contrast. (they don't even allow them in the main article)

The mechanism section: No they don't, at least not the beneficial effects. Together with: it suggests that the situation in Europe is fundamentally no different: be it through milk, salt or water fluoridation, the systemic intake would be comparable to countries with water fluoridation. that is not the case. Also, Switzerland and Germany are the only european countries where most salt is fluoridated.
 * Fluoride's effects depend on the total daily intake of fluoride from all sources.
 * others, such as in Europe, using fluoridated salts as an alternative source of fluoride

Which countries? Only Sweden provides free dental treatment for schoolchildren afaik. Eastern Europe did the same during the communist era, but those days are long gone. They may get free check-ups in some countries, and a note for the parents telling them they need to go see a dentist, that's about it. It's not the only doubtful claim about "many countries", "most people", ..
 * unlike most European countries, the U.S. does not have school-based dental care

WHO DMFT data for 12-y olds in 2004 shows W. European countries scoring as good as or better than the U.S. and Canada. Helen Whelton's study shows much more cases of dental fluorosis in areas with water fluoridation or high natural fluoride content. which makes the statement dental fluorosis, which is mostly due to fluoride from swallowed toothpaste., although technically correct, a bit misleading.109.66.59.99 (talk) 18:15, 29 March 2014 (UTC)


 * Well, I don't know enough about this subject to comment on all of the remarks above, but the full version of the final report is found here: http://ec.europa.eu/health/scientific_committees/environmental_risks/docs/scher_o_139.pdf


 * 1 “Fluoride is not an essential element for human growth and development…” Does the article say it is? I did not see that.


 * 2 “Systemic exposure to fluoride through drinking water is associated with an increased risk of dental and bone fluorosis in a dose-response manner without a detectable threshold.” Yes, but mild dental fluorosis has almost no clinical significance at all and "intake of less than 0.1 mg F/kg BW/day in children up to 8 years old corresponds to no significant occurrence of “moderate” forms of fluorosis in permanent teeth". The report also states that skeletal fluorosis has not been observed in the EU with the exception of certain industrial workers with high exposure associated with their jobs. So the lead sentence seems to be discussing a phenomenon that is detectable but without clinical significance at fluoride levels associated with water fluoridation.


 * 3. “For younger children (1-6 years of age) the UL (The upper tolerable intake level) was exceeded when consuming more than 1 L of water..." This might be worth looking into.


 * 4. "The efficacy of population-based policies, e.g. drinking water, milk or salt fluoridation, as regards the reduction of oral-health social disparities, remains insufficiently substantiated." Yes, but the report waffles on this point. Elsewhere it states "Water fluoridation as well as topical fluoride applications, e.g. fluoridated toothpaste or varnish, appears to prevent caries, primarily on permanent dentition, but topical application is the more efficient measure", "water fluoridation offers additional benefits over alternative topical methods because its effect does not depend on individual compliance", and "The effect of water fluoridation tends to be maximized among children from the lower socio-economic groups, so that this section of the population may be the prime beneficiary"


 * Overall, I can see some possible concerns about the overall balance of this article, but I'm also struck that the SCHER report waffles a lot and that there may be some selective quotation in the above critique. — Preceding unsigned comment added by Formerly 98 (talk • contribs) 13:11, 30 March 2014 (UTC)

SCEHR
A recent edit tried to say that the EU considers fluoridation as "controversial"; while true in a general sense due to the external controversies and advocacy, this implies that the document considers the benefits "controversial" which it clearly does not, "Fluoride, either naturally present or intentionally added to water, food and consumer products, e.g. toothpaste, is generally considered beneficial to prevent dental caries." Adding this text to the lead without context would seem inappropriate. Yobol (talk) 20:03, 2 April 2014 (UTC)


 * You are misquoting the document . it doesn't write "EU considers fluoridation as controversial" it writes "Artificial fluoridation of drinking water reaches the whole population, but is a controversial as a public health measure". That is the position of the EUs "CDC" . You may not like it. but that is what it is. stop reverting this editLarryTheShark (talk) 20:19, 2 April 2014 (UTC)
 * It is controversial because others have made it controversial. The benefits are not controversial, as the quote from the professional summary shows. Yobol (talk) 20:22, 2 April 2014 (UTC)
 * That is your personal POV. which is violating WP:OR, there is a whole section above going in detail. “Scientific evidence for the protective effect of topical fluoride application is strong, while the respective data for systemic application via drinking water are less convincing. No obvious advantage appears in favor of water fluoridation as compared with topical application of fluoride.”LarryTheShark (talk) 20:35, 2 April 2014 (UTC)
 * Which means they found it beneficial. Yobol (talk) 20:45, 2 April 2014 (UTC)
 * Which means the benefit to risk ratio doesn't justify it when other avenues of fluoride usage are available.LarryTheShark (talk) 21:04, 2 April 2014 (UTC)
 * That's your interpretation, not the doucment's. The document summary says "Fluoride, either naturally present or intentionally added to water, food and consumer products, e.g. toothpaste, is generally considered beneficial to prevent dental caries." Yobol (talk) 21:06, 2 April 2014 (UTC)
 * I have not added any interpretation to the article. this is what you are trying to do. I have used the exact words of the document. hence NPOV. the USA is a water fluoridation hugger. the EU is not. similar to position about GMO's : USA is YES, and EU is NO. LarryTheShark (talk) 21:24, 2 April 2014 (UTC)
 * Without saying what is controversial about it, saying it is "controversial" is a WP:WEASEL...it suggests that the controversy is possibly "good vs bad" or "more vs less" or "what chemical to use" or any number of other aspects of it. By popular media, "controversial" generally means for-vs-against. Some of those possible meanings are clearly not what the source supports, and not-defining the scope of the controversy means you're open to interpretation in a way that has negative connotations and not supported by ref. DMacks (talk) 21:45, 2 April 2014 (UTC)
 * The EU general statement belongs after the CDC general statement. they are of the same quality.
 * WP:WEASEL talks about " Claims about what people say, think, feel, or believe, and what has been shown, demonstrated, or proved should be clearly attributed". The sentence put in the article is clearly attributed and sourced. what should be done is adding more information in the body of the article of the EU position. as requested in the section above
 * You also forgetting that the EU doesn't practice water fluoridation (same like the vast majority of the world). Their statement also reflects the continent practice.
 * According to the British Fluoridation Society (2012) : Most developed nations do not fluoridate their water. In western Europe, only 3% of the population consumes fluoridated water. While 25 countries out of 193 worldwide have water fluoridation programs, 11 of these countries have less than 20% of their population consuming fluoridated water: Argentina (19%), Guatemala (13%), Panama (15%), Papa New Guinea (6%), Peru (2%), Serbia (3%), Spain (11%), South Korea (6%), the United Kingdom (11%), and Vietnam (4%). Only 11 countries [2014 only 10] in the world have more than 50% of their population drinking fluoridated water: Australia (80%), Brunei (95%); Chile (70%), Guyana (62%), Hong Kong (100%), the Irish Republic (73%), {stop in 2014} Israel (70%), Malaysia (75%), New Zealand (62%), Singapore (100%), and the United States (64%). In total, 377,655,000 million people worldwide drink artificially fluoridated water. This represents 5% of the world’s population. There are more people drinking fluoridated water in the United States than the rest of the world combined.LarryTheShark (talk) 22:10, 2 April 2014 (UTC)

Edits reverted of 4/4/14
Editor adding only anti-fluoridation content to the article. Suspect POV editing. Should not edit on topics which we have strong opinions about, instead either avoiding them or editing neutrally. These edits were not neutral imo. Request demonstration that there is a consensus for such edits to this article using the talk page. Regards, Lesion  12:26, 4 April 2014 (UTC)


 * Here is the diff: . Lesion  12:27, 4 April 2014 (UTC)


 * My last edits have been reverted Carte blanche, by the editor 'Lesion' who seems to be a water fluoridation advocate, on the ground of "anti-water fluoridation content and changing the previous tone of the article".


 * I find that accusation spurious.


 * Non of my references are coming from anti fluoridation websites. my references and statements are coming from major and consensus scientific reviews: 2000 York review/2003 addition, 2007 UK, Cheng review and 2011 EU SCHER review. The "tone" of a wikipedia article should represent WP:NPOV information. and with my edits, it does.LarryTheShark (talk) 12:37, 4 April 2014 (UTC)
 * When I described your edits as "anti-water fluoridation" my meaning was each edit seemed to be adding content which was worded to oppose water fluoridation. Sources sound ok, I haven't checked them, but not sure about how they are being used. Please seek consensus. Thank you, Lesion  12:55, 4 April 2014 (UTC)


 * Incredible. so you have not checked the information. and you revert. that is called personal POV.
 * Another editor/fluoride advocate, reverted on the grounds of "cherry picked quotes changing the POV of the article" deliberately omitting that most statements are backed/quoted by not 1 but 2 major sources.LarryTheShark (talk) 13:03, 4 April 2014 (UTC)


 * P.S. do not change the subject of this section which i have started to your POV.LarryTheShark (talk) 13:06, 4 April 2014 (UTC)

In an attempt to move things forward, I will start discussion about one of the more concerning edits (not all were this POV):

Is a major change in the previous tone of the article. Can we demonstrate that this view is supported by the majority of sources? Lesion 13:10, 4 April 2014 (UTC)


 * Certainly. the two references are the 2011 EU SCHER major review + UK, Cheng 2007 review. The EU uses the word "Less convincing" and Cheng uses "relatively poor" .The 2000 UK York review is much harsher (i have not placed in the lead but in the 'Evidence' section lead):

http://www.york.ac.uk/inst/crd/fluoridnew.htm


 * What authoritative sources you have stating otherwise? LarryTheShark (talk) 13:19, 4 April 2014 (UTC)
 * I am mostly unfamiliar with the literature here, but just had a look through the first page of pubmed results with keywords "water fluoridation", and the scientific consensus appears to be strongly in favor of water fluoridation. Therefore a series of edits each adding content which is worded to oppose water fluoridation is questionable. Would appreciate if you gave rationale to each edit here as above, so we can move towards a consensus for each. Lesion  13:36, 4 April 2014 (UTC)


 * Your approach is WP:OR and amateur work. This is why the scientific community relies on Reviews/Meta analysis of studies. All the reviews (except for the australian) say that the evidence is of relatively poor quality. and this is what i stated in my edit.LarryTheShark (talk) 13:42, 4 April 2014 (UTC)
 * There have been only 3 reviews since 2000? Encourage you to make one of these threads for each edit, so it doesn't look like an editor adding anti water fluoridation content over and over. Lesion  13:48, 4 April 2014 (UTC)


 * Yes. Those are the major reviews. York 2000 study for UK government (the country fluoridates 11% of population)), Cheng 2007 (UK, independent), Australia 2007 for the australian government (the country fluoridates 80%), EU SCHER 2011 for the European Union (EU 3% water fluoridates). the very reference that is now in the article (from ireland, 73% fluoridate) states "While the reviews themselves were of good methodological quality, the studies included in the reviews were generally of moderate to low quality" there is no controversy that the studies used to show water fluoridation works are "relatively poor and less convincing" only the Australians think they are "great" LarryTheShark (talk) 14:12, 4 April 2014 (UTC)
 * Just reading the intro to this in progress Cochrane review, and it suggests that the 2000 York study was comprehensive, but needs to be updated. OK then I would happy with something like that, not sure how others feel. Could be worded better imo: "Water fluoridation prevents cavities in both children and adults, although the evidence for this is relatively less convincing than the strong evidence for the preventative benefit of topical fluoride.[reviews]" Lesion  14:20, 4 April 2014 (UTC)h
 * If we are to discuss the relative strength of evidence between topical/water fluoridation it should belongs in the "Alternatives" section where other forms of fluoridation are discussed, probably not in the lead of the effectiveness section. Yobol (talk) 14:32, 4 April 2014 (UTC)
 * Sounds reasonable. Lesion  14:36, 4 April 2014 (UTC)
 * Agree... The stronger evidence for the effectiveness of topical doesn't make fluoridation of water not effective. The two strategies have different purposes.  In particular the sources repeatedly point to the utility of water fluoridation for the dental health of the poor.    14:41, 4 April 2014 (UTC)


 * No. water fluoridation efficacy is based on poor quality research. this is referenced solidly and is NPOV significant information. the only ones wanting to hide this are water fluoridation advocates.LarryTheShark (talk) 14:47, 4 April 2014 (UTC)
 * Re to Zad, good point. Not sure if "topical fluoride" refers to toothpastes as well as concentrated fluoride that dentists use. Water supply reaches everyone in society, not just those parents who take their kids to the dentist to get topical fluoride or even to bother to buy fluoride toothpaste. Probably the best way to get fluoride to those people who would otherwise never get it. Perhaps this should be added to the comment comparing the relative strength of evidence available for topical and water fluoridation.  Lesion  14:57, 4 April 2014 (UTC)

Well, the admins blocked the editor, so I don't know if anyone wants to go through each of these edits. The thing about there being relatively less evidence for water fluoridation compared to topical application of fluoride is supported by a comprehensive review (at least according to cochrane). As mentioned above, suggest add qualifier to that statement that water fluoridation has potential to reach much more people than topical application can. Lesion 16:47, 4 April 2014 (UTC)

SCHER
OK, starting to look at the "SCHER" source, which is being characterized here as a "major review". I do not find support for this characterization. The SCHER appears to be one of several relatively small advisory bodies which produce opinion papers, and their recommendations are not binding. They publish their own works and so are self-published. Their papers are not carried by the standard major databases of biomedical articles, like PubMed or MEDLINE. I cannot find any major news sources that regularly carry articles covering their publications, like I can find for major medical organizations. Therefore I do not find any support for giving their viewpoint significant weight in our article. They may--maybe--deserve a brief mention, making sure we follow WP:ATTRIBUTEPOV, but I do not see justification for making significant use of their publication. 13:58, 4 April 2014 (UTC)
 * The SCHER summary states, "Fluoride, either naturally present or intentionally added to water, food and consumer products, e.g. toothpaste, is generally considered beneficial to prevent dental caries." Beneficial. LarrytheShark has cherry picked and turned every single negative commentary about fluoridation out of that review, apparently to push an agenda. Yobol (talk) 14:07, 4 April 2014 (UTC)
 * I should note that our article contains a number of different secondary sources that support fluoridation and so cherry picking the only negative ones/only negative comments from secondary sources, while ignoring the positive ones, appears to be more POV pushing. Yobol (talk) 14:10, 4 April 2014 (UTC)
 * Not disagreeing... so, other than this publication not being clearly authoritative, and the suggested edits based on it misrepresenting it, what's the problem??? :-P   14:15, 4 April 2014 (UTC)

On the topic of reliable sources, there is a cochrane review but it looks like it is currently in progress. Lesion 14:12, 4 April 2014 (UTC)
 * Yes, when that review is published, it will certainly be useful here. What's interesting to note is that the SCHER publication isn't listed among the nearly 30 references they list.    14:20, 4 April 2014 (UTC)


 * Amazing, shameless POV pandering. (If you can't kill the message, try to delegitimize the messenger).
 * The Yeung CA. review (which is used in the article) purpose is "The systematic review was commissioned by the Australian National Health and Medical Research Council (NHMRC) to evaluate the scientific literature relating to the health effects of fluoride and fluoridation."
 * The SCHER review purpose is "To obtain an up to date scientific view on the matter [fluoridation of drinking water] the European Commission asked the Scientific Committee on Health and Environmental Risks (SCHER) to elaborate an opinion on the safety of fluoride" http://ec.europa.eu/health/publications/docs/achievements2010_en.pdf (page 30)
 * Ant yet Zad is trying to belittle it.
 * The EU Commission position on water fluoridation is posted on their own Public health positions section in detail. http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/ these positions which are based on the SCHER fluoride review. Not giving them 'significant weight in the article' is to omit/censor the European Union official view on water fluoridation in whole !LarryTheShark (talk) 14:39, 4 April 2014 (UTC)
 * If you really wish to be a productive Wikipedia editor, you really should familiarize yourself with how WP:NPOV is determined on Wikipedia. We take into account the strength and authority of a source in determining how much weight to give it in an article.    14:45, 4 April 2014 (UTC)
 * (e/c) The Yeung review has the added benefit of undergoing independent peer review and being published in a journal, while the SCHER review is not, making one more authoritative than the other. That being said, I would consider including a minor role for SCHER analysis, as they serve a similar role as say, the FDA, in doing independent analysis for governmental consumption. Since SCHER's view is that water fluoridation is beneficial, trying to cherry pick negative commentary out of the review that goes against this conclusion will not go anywhere. Yobol (talk) 14:51, 4 April 2014 (UTC)
 * Exactly... Because their publication doesn't appear to be peer-reviewed, or have had to go through an acceptance process to be picked up for publication and indexed by a database like MEDLINE, what I'm having trouble finding is evidence that the SCHER's publication is authoritative and influential. Statements from the FDA, for example, get picked up by news sources all the time.  I can't find the same for the SCHER.    14:56, 4 April 2014 (UTC)

Ethics and Politics Section Update
As I was going through this section today, I noticed that some of the referenced surveys are a bit old (e.g., 1999). Do we have newer surveys and studies to replace them? If so, we should probably do that. TylerDurden8823 (talk) 18:46, 4 April 2014 (UTC)

The entire article is written like an advertisement for the promotion of water floridation. No section or even paragraph highlighting possible cause for concerns. — Preceding unsigned comment added by 78.151.186.121 (talk) 18:14, 5 April 2014 (UTC)
 * There's a whole article dedicated to that controversy. Please see Water fluoridation controversy. Your comment also has very little to do with this particular section... TylerDurden8823 (talk) 01:41, 6 April 2014 (UTC)

Cost needs updating
Fluoridation does not cost $1.02 per year; it's $3 per month. Source: my water bill. (South Salt Lake, Utah) It does not lend credibility to presume the average household have 35 people.--Choshek (talk) 21:39, 23 April 2014 (UTC)


 * I suspect that the amount that you are charged has very little to do with what the process actually costs the utility company. (Though it could be that there are significant overheads associated with small-town supplies; larger communities may enjoy significant economies of scale.)  The fluoride charge in South Salt Lake is a flat rate per water connection; it is not based on household water usage.  TenOfAllTrades(talk) 23:59, 23 April 2014 (UTC)

USPSTF
States "In April 2013, the Community Preventive Services Task Force recommended fluoridation of community water sources based on strong evidence of effectiveness in reducing dental caries" based on   Doc James  (talk · contribs · email) (if I write on your page reply on mine) 19:53, 6 May 2014 (UTC)

Insufficient sourcing
This got removed for insufficient sourcing. However, it has four sources that cover the text. Sources: Njaohnt (talk) 00:04, 29 April 2014 (UTC)
 * Calcium fluoride (CaF2) is naturally occurring in many water sources. It is the only type that is not toxic, as other fluorides have been shown to lower IQ. It also has been shown to help teeth, as there is little indication that hydrofluorosilicic acid helps teeth, and there is evidence that it causes fluorosis.
 * http://www.fluoridefreewinnipeg.com/http___www.fluoridefreewinnipeg.com/WHAT_FORM_OF_FLUORIDE_IS_WINNIPEG_DRINKING_2.htm
 * articles.mercola.com/sites/articles/archive/2011/08/12/fluoride-and-the-brain-no-margin-of-safety.aspx
 * http://www.gov.mb.ca/health/publichealth/environmentalhealth/docs/factsheet_fluoride.pdf
 * www.prisonplanet.com/calcium-fluoride-vs-sodium-fluoride.html


 * See WP:MEDRS for the kinds of sources that are acceptable to support biomedical claims (and which sources are not, like activist websites). The CA government website doesn't mention CaF2.    00:16, 29 April 2014 (UTC)


 * Actually first 3 of those references don't appear to mention calcium fluoride at all, the 4th one does mention it, but doesn't state that it naturally occurs in water.Project Osprey (talk) 00:20, 29 April 2014 (UTC)


 * Wow. The first one is a terrible source. ("Contaminated with the artificial fluoride ion..."&mdash;really?  Apparently the aqueous F- ion from dissolved CaF2 is 'natural', whereas the aqueous F- ion from dissolved NaF is 'artificial'.  Seriously.  The scientific illiteracy hurts to read.)  The second and fourth sources are crappy, too, with similar inability to understand basic chemistry.  The third source has nothing to do with the proposed text, and obviously does not support it.  Has Njaohnt actually read and understood the pages that he's linking to, or is he only accidentally wasting our time?  TenOfAllTrades(talk) 01:24, 29 April 2014 (UTC)
 * I have added sources, and changed the text. Will this be okay?
 * Calcium fluoride (CaF2) is naturally occurring in many water sources. It is the only type that is not toxic, as other fluorides have been shown to lower IQ, cause neurological developmental issues, and cause fluorosis.
 * Sources:
 * http://www.fluoridefreewinnipeg.com/http___www.fluoridefreewinnipeg.com/WHAT_FORM_OF_FLUORIDE_IS_WINNIPEG_DRINKING_2.htm
 * articles.mercola.com/sites/articles/archive/2011/08/12/fluoride-and-the-brain-no-margin-of-safety.aspx
 * http://www.gov.mb.ca/health/publichealth/environmentalhealth/docs/factsheet_fluoride.pdf
 * www.prisonplanet.com/calcium-fluoride-vs-sodium-fluoride.html
 * http://fluoridedetective.com/types-of-fluoride/
 * http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/
 * http://afamildura.wordpress.com/fluoridation-chemicals/
 * http://preventdisease.com/home/tips79.shtml
 * Njaohnt (talk) 14:20, 11 May 2014 (UTC)


 * No. I'm not sure how to be any clearer than I was before.  Both CaF2 and NaF produce exactly the same fluoride ion (F-) when dissolved in water.  The body doesn't know which counterion – calcium or sodium – the fluoride was previously associated with.  ('Worse' still, virtually all drinking water contains at least trace amounts of sodium (a few parts per million: not enough to taste); if you evaporate the water down to precipitate the salts, you're going to get some sodium fluoride back out, even if all of the fluoride in the water was originally added by dissolving calcium fluoride.)
 * The sources that insist there is a magical difference between fluoride ion from calcium fluoride and from sodium fluoride are wrong, and they definitely are not reliable sources by any Wikipedia standard. Try to find at least one source that is a proper, peer-reviewed, scientific journal article – and not a press release, blog, or advocacy site – that supports the specific claim that you're trying to insert into the text here.  And be prepared to provide a direct quote of that source to show that it supports your proposed wording.  Otherwise, you're just wasting our time.  Again.  TenOfAllTrades(talk) 14:52, 11 May 2014 (UTC)
 * Agreed. Maybe it would be best to identify just one source, maybe one you feel is especially good, and we can discuss it. --Ronz (talk) 14:58, 11 May 2014 (UTC)

Does this mean the LD50 of Calcium fluoride, Sodium Fluoride, and hexafluorosilicic acid are equal? What does LD50 mean exactly? And could you clarify which fluoride compound is used in water fluoridation and why? — Preceding unsigned comment added by 99.61.176.89 (talk) 01:25, 26 May 2014 (UTC)

Toxicity of sodium fluoride
Please include sodium fluoride toxicity. Note that it is a poison. Unlawful to dispose off. Fraudulent medicine. — Preceding unsigned comment added by 222.153.137.47 (talk) 12:24, 26 April 2014 (UTC)
 * According to the article sodium fluoride, NaF has a relatively low toxicity. As a poison, several grams would need to be consumed by a typical adult human.  You are almost certainly correct about its disposal, which is probably regulated, depending on your home country.  The use and disposal of chemical compounds generally are regulated.  If you have reliable references to the use of NaF in fraudulent medicine, that might be of interest in the article on sodium fluoride.  --Smokefoot (talk) 12:46, 20 June 2014 (UTC)

Good article
This article is great because it shows both negative and positive while simultaneously not discriminating any which side, while making both sides agree their points of view. Qwertyxp2000 (talk) 22:16, 27 June 2014 (UTC)

Fluoridation Controversy section could still be more objective...
I'm definitely not anti-fluoridation, but objectivity is a goal of mine. Some parts of the controversy section seem like they're slightly biased towards fluoridation. For instance, "Antifluoridation arguments are, "often based on Internet resources or books that present a highly misleading picture of water fluoridation".[28]" could be phrased more objectively, such as "According to many experts, antifluoridation arguments..." or "According to Jason Armfield, antifluoridation arguments..." so that people pay more attention to the fact that what's being said is a quote rather than an absolutely true fact (which I do believe it is, anyways, but we still should try to be as unbiased as possible). Also I cannot edit it yet, because I am a relatively new user. Ptb1999 (talk) 13:11, 30 August 2014 (UTC)
 * there is a well organized gang of editor/thugs that revert any change made that seeks to document the position of the anti-fluoridation group. Jtbobwaysf (talk) 16:55, 1 September 2014 (UTC)
 * Well it is unhelpful to resort to name-calling when one does like an article. A huge amount of effort has been dedicated to this one.  And there is this: Water fluoridation controversy, which is prominently cited in the main article.  The plain fact is that Wikipedia generally reflects the positions of the most authoritative sources.  A good example is evolution, which is intensely controversial for some (like the majority of Americans, apparently), but the article gives no quarter to creationist views. --Smokefoot (talk) 18:07, 1 September 2014 (UTC)
 * If you have sources that you would like to see included in the article, I encourage you to present them here for discussion. We'll be happy to consider them.  Andrew327 20:52, 1 September 2014 (UTC)

dental flourosis
Hello. In the article it is stated that dental fluorosis happens in children between 1 and 4 years old. Directly to the right their is a picture of a mouth exposing teeth with fluorosis. The teeth in the picture cannot possibly belong to a child. Is this an outright lie? sodium fluoride is the main ingredient in rat poison. I believe that facts like this should be listed as well. Thanks. I love Wikipedia! — Preceding unsigned comment added by 71.93.215.94 (talk) 01:21, 11 September 2014 (UTC)
 * I suspect that its simply the best (or only) image we have of detal fluorosis. Before they emerge your adult teeth develop within your gums, this development happens when you are still a child. That’s what the article is referring to, perhaps the wording could be made more clear. Certain chemicals which contain fluorine such as Sodium fluoroacetate, 1,3-Difluoro-2-propanol and Fluoroacetamide are used as rat poisons but these are organofluorine compounds are aren't sources of fluoride (chemically that quite different and biologically very different) - I've never heard of sodium fluoride being used as a rat poison, do you have a reliable source for that? Project Osprey (talk) 09:07, 11 September 2014 (UTC)
 * Whether NaF is used in rat poison or other stuff is not very relevant. I think that it was used in rat poison at one time. It is not very toxic, one needs grams to kill someone. The single-issue (always unregistered, always single issue) editors on this theme are obsessed with highlighting any connection that could possibly disparage the poor old fluoride ion and boost their contention that fluoridation is used for all sorts of nefarious reasons and part of some grand conspiracies rooted in the Nazi and John Birch Society lore. --Smokefoot (talk) 13:02, 11 September 2014 (UTC)

Proposal for a table
Regarding the usage or not in various countries, perhaps we could add a table. I cannot vouch for this link []. Politis (talk) 08:21, 15 September 2014 (UTC)
 * Seems like a good idea to me Jtbobwaysf (talk) 06:21, 27 September 2014 (UTC)
 * Two comments. 1) The source is awful - advocacy group and wacked out.  The parent website is maintained by "...desktop-publishing Editor from 1998-2002 for Fluoride, the journal of the International Society for Fluoride Research. ..", a journal isso disreputable so as to be refused recognition by PubMed (U.S. National Institutes of Health), a remarkable feat in scientific publishing.  Sources connected to that organization do not rise to the standards here.  2) probably such a table, if you can find a source, would belong in Fluoridation by country. --Smokefoot (talk) 19:07, 27 September 2014 (UTC)

Major problems in the worldwide-use map
Looking over the world usage map (in the article and at http://en.wikipedia.org/wiki/Water_fluoridation#mediaviewer/File:Fluoridated-water-extent-world.svg ) I notice a few problems: 1) It is over five years old, apparently based on data that is over ten years old (One in a Million, 2004), yet the reference cites the 2012 version of One in a Million, 2) Brazil is shown as a very large red area at 60-80% usage, whereas the 2012 One in a Million lists Brazil at 41% artificial fluoridation. I see no way to come up with the other 19% from natural fluoride, 3) Colombia is shown at 60-80% usage, whereas 2012 One in a Million indicates no artificial fluoridation and under 2% extent of natural fluoride there, 4) Israel has discontinued fluoridation, but is shown at 60-80%, 5) the source code for the map seems to be unavailable, 6) very large areas of India have a problem with excessive natural fluoride, and India's level is indicated as unknown, 7) the map claims to show natural plus artificial fluoridation, whereas the main topic of the article is artificial fluoridation. So this graphic can easily mislead the reader. 8) the article has a good separate map showing excess natural fluoride.

I believe we need an up-to-date map showing only artificial water fluoridation. CountMacula (talk) 16:33, 2 January 2015 (UTC)

Dead Link
The link to the news article about the accidental release of 60 gallons of fluoride in 90 minutes in Asheboro, North Carolina no longer leads to the article. The reference number is 62 at the bottom of the page. I tried to find another news article regarding the event but couldn't find one. (I didn't look for very long). (Griffin9898 (talk) 23:55, 10 January 2015 (UTC))

Suggested updates
I would suggest to include information and links from a research report from the Journal of Epidemiology and Community Health entitled: "Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water". This research report highlights evidence for the association between the fluoridation or drinking water and hypothyroidism.

The link for the research report is here:
 * http://jech.bmj.com/content/early/2015/02/09/jech-2014-204971.abstract?sid=387994a1-4d28-493a-bef6-8fdf845ecbb0

Also here is a link to a Newsweek article which discusses the findings of this report:
 * http://www.newsweek.com/water-fluoridation-may-increase-risk-underactive-thyroid-disorder-309173 — Preceding unsigned comment added by Buffalojack (talk • contribs) 13:58, 1 March 2015 (UTC)

I suggest inclusion of the concerns articulated in the 2006 NRC report on Fluoride in Drinking Water; a reference to the “neutral” stand of the National Kidney Foundation per 2008 position paper that advises warnings for children, the elderly and those with renal impairments; expanding on the last paragraph by acknowledging that the EPA concedes that dental fluorosis could be avoided by reducing the fluoride exposure of children under 3 (the CDC mentions under 8 and the ADA advises under 6 months) - warnings now being included on some city water quality statements; and a mention of Kaj Roholm.

You might also give a nod to the validation of the fluoride opponents complaints of “poor quality” and incorrect interpretations of trial 1950-1990 trials (see Philip Sutton for early trials ) by modern CDC, ADA and PHS. Here are some references for the primary author if he is so inclined to research these suggestions and include them in the article:

Seabreezes1 (talk) 20:17, 3 October 2014 (UTC)
 * http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf
 * http://www.toxipedia.org/display/toxipedia/Grand+Rapids+first+use
 * http://water.epa.gov/drink/contaminants/basicinformation/fluoride.cfm#three
 * http://jada.ada.org/content/141/10/1190.abstract
 * http://www.cdc.gov/fluoridation/faqs/dental_fluorosis/index.htm
 * http://www.ncbi.nlm.nih.gov/pubmed/10728978?dopt=Abstract
 * http://www.kidney.org/atoz/content/fluoride
 * articles.mercola.com/sites/articles/archive/2012/04/24/fluoride-warnings-on-water-bills.aspx
 * http://www.ncbi.nlm.nih.gov/pubmed/24561004
 * Links are helpful http://www.science20.com/the_fluoride_informer/dentists_admit_fluoride_bad_for_kidney_patients
 * What is the text you wish to add? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:11, 3 October 2014 (UTC)
 * EVIDENCE
 * Existing evidence XXXXX suggests that water fluoridation reduces tooth decay. Consistent evidence also suggests that it causes varying levels dental fluorosis, most of which is mild and affects less than 50% of the enamel surfaces XXXXXX.[10] However, per the 2004 CDC analysis, 3.6% of American 14 year olds exhibit moderate to severe fluorosis, characterized by brown staining and pitting and impacting over 50% of their enamel surfaces. It is anticipated that those affected to this degree will require veneers or crowns for both aesthetic and structural reasons. (http://www.cdc.gov/nchs/data/databriefs/db53.htm) Despite the claims of efficacy and safety, there is a consensus that almost all 20th century research on the impact of fluoride has been of poor quality.[11]


 * Due to our emerging understanding of the development of dental fluorosis and the primary effectiveness of fluoride as a topical prophylactics, dental and medical organizations recommend not giving infants and small children fluoridated water or any drink made with fluoridated water. A growing number of city Boards of Health are including this warning on their water reports in an effort to prevent dental fluorosis. (http://jada.ada.org/content/141/10/1190.abstract)


 * EFFECTIVENESS
 * Water fluoridation is believed to reduce cavities in both children and adults:[9] earlier studies showed that water fluoridation reduced childhood cavities by fifty to sixty percent, but more recent studies show lower reductions (18–40%) likely due to increasing use of fluoride from other sources, notably toothpaste, and also the 'halo effect' of food and drink that is made in fluoridated areas and consumed in unfluoridated ones.[2] (I suggest you research that 40% figure better and that whole “halo” effect. More is not better… more is more toxic, and causes gum disease. Look up “denti neri”) Some studies indicate that the actual rate is lower due to an apparent delay in carie development in fluoridated communities. (Author is a member of 2006 NRC with a speciality in statistical analysis and risk assessment: http://www.regulations.gov/#!documentDetail;D=EPA-HQ-OPP-2011-0173-0009)


 * The 2006 National Research Council report on Fluoride in Drinking Water, sponsored by the National Academy of Science found that a lifetime exposure to fluoride is likely to increase the bone fracture rate, particularly in populations susceptible to accumulation of fluoride, such as those with reduced kidney function. The Council also found that there were significant gaps in the available information on dental and bone health at lower levels of exposure. The Council recommends filling these gaps as well as exposure assessment at the individual level and more studies focusing on endocrine and brain function. (http://dels.nas.edu/resources/static-assets/materials-based-on-reports/reports-in-brief/fluoride_brief_final.pdf)


 * Partially in response to the NRC report, the National Kidney Foundation has withdrawn its support of water fluoridation, adopting a neutral position. The NKF advises patients with chronic kidney disease (CKD) to avoid ingesting fluoride, as well as requiring non-fluoridated water for dialysis. The NKF also advises that those at risk of developing CKD, children, those with excessive fluoride intake, and those with prolonged disease monitor their fluoride intake. The reduced capacity of the kidney to excrete fluoride leads to the life long acculmination of fluoride in the body, leading to a state of chronic fluoride intoxication as described by Dr. Kaj Roholm. (http://www.kidney.org/atoz/content/fluoride)


 * Dr. George Waldbott observed and described the early stages of fluoride intoxication in some of his patients during the 1950s and 1960s. As an allergist, Dr. Walbott’s patients likely comprised a susceptible population. However, sensitivity to fluoride is typically not an allergic response, but a dose sensitive response to what is essentially a poison.


 * Ending paragraph
 * National studies by the CDC indicate that race and income level are more of a factor in the development of caries than fluoridation. (http://www.cdc.gov/nchs/data/databriefs/db104.pdf)


 * The Ethics & Politics section is better than some, but still has a POV that is less than neutral. Example: fluoridation is not like vaccinations, except in this way. Because of health reasons, as a child in the 60s, I had a medical exemption from the smallpox vaccination. When I was 17 and wanted to travel, I was vaccinated. Water fluorination does NOT allow for this type of individual consideration. However, I’m sure I wouldn’t be able to suggest any edits in this section that wouldn’t be perceived as having an opposing POV.


 * This is my good faith effort to respond to your query and improve the quality of the articleSeabreezes1 (talk) 23:28, 3 October 2014 (UTC)
 * The refs are unformatted. We are not adding content like "Existing evidence XXXXX suggests that water fluoridation reduces tooth decay." No idea what XXXXS is. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:24, 4 October 2014 (UTC)
 * The ref does not say "However, per the 2004 CDC analysis, 3.6% of American 14 year olds exhibit moderate to severe fluorosis, " is due to water fluoridation. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:33, 4 October 2014 (UTC)
 * Were is the content that supports "It is anticipated that those affected to this degree will require veneers or crowns for both aesthetic and structural reasons" Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:36, 4 October 2014 (UTC)
 * This is also not supported "dental and medical organizations recommend not giving infants and small children" This is a primary source not the position of a dental or medical organization  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:42, 4 October 2014 (UTC)
 * The material about the NKF is also not supported by the cited source, which explicitly does not take a position about water fluoridation. Material about Waldbott and Roholm appear tacked on (these are scientists who published in the 1930s and 40s, and no sources have been presented to suggest their relevance to 2014). I see no material from the above suggestions that I would include in this article. Yobol (talk) 00:43, 4 October 2014 (UTC)
 * The XXXX was just to show how I edited a paragraph in the EXISTING article for the purpose of making it easier for your review. Ditto with my parenthetical references and comment. The CDC report gives the figures. I did the addition. Any research into the severity of fluorosis indicates that moderate and severe dental fluorosis does require treatment, which is why there is so much emphasis on minimizing it as mostly mild. And, no, the ADA does recommend that although fluoridated water is safe, that infant formula should not be made with it on a regular basis, and the primary research I provided seemed the simplest way to make that point to the editor. As to the BOH including these warnings, there is no single great reference for that, but there are many current news articles on the topic, i.e. common knowledge. The NKF is a lot of double speak,  that takes a bit of review, but yes, they do state those exact words. And yes, I did tack on the bits about Waldbott and Roholm, as I did not expect every paragraph to be placed in en masse as written in one section. However, the article included info on Dean, who not only used his work but consulted with Kaj Roholm who advised that water fluoridation was ill-advised. I didn't want to go that far on this article, but any article that touches on the history of water fluoridation should acknowledge the world's leading expert in the 1940s.
 * You made no comments on the NRC - which is a totally citable source that reviewed the literature and made serious recommendations regarding safety, nor the comments on the EPA's response to the NRC from another very citable source, http://www.orrisk.com/about.html. Again, Dr. Thiessen was a member of the NRC. I suggest that the material I presented is an opportunity for improving the article. Seabreezes1 (talk) 01:37, 4 October 2014 (UTC)

Sorry to jump in, but we dont want any credible article citing "A founder of the International Society for Fluoride Research." This is the front organization for the Mom&Pop club that publishes the journal Fluoride, which is so disreputable that PubMed will not index it. That kind of quackery gets no standing in Wikipedia. Also including him would invite a long list of people pro and anti, and we get into an endless cycle of debating authority. --Smokefoot (talk) 04:03, 4 October 2014 (UTC)
 * Where did you get that? I'm not quoting any anti-fluoridationists, I'm quoting the National Research Council, the National Kidney Foundation and the CDC. Plus, because I understand fluoridation is a controversial topic, I'd rather not write the material into the article myself, only ask the editor to consider these sources and include what he deems fair. The only reference to a person, was the author of the comments who was a member of the 2006 NRC committee, here is her bio: http://www.orrisk.com/thiessen_bio.html Seabreezes1 (talk) 12:36, 4 October 2014 (UTC)
 * The article on George Waldbott indicates that he is founder of what is basically Fluoride Action Network. Last line of the text.  Alsothe October 1982 issue of Fluoride has a biography/obituary: "the society's founder and the editor of its official journal FLUORIDE since its inception in 1968, ..."  --Smokefoot (talk) 15:05, 4 October 2014 (UTC)
 * Ahh, Dr. Waldbott was a leading allergist and researcher who first described penicillin allergies, human anaphylactic shock and "Smoker's Respiratory Disease" which connected cigarettes with what was considered up to that point to be "asthma." Today's common knowledge about the history of the opposition to fluoride dismisses the real scientific debate in the early years that included reputable scientists about what was essentially a human trial based on a scientific hypothesis. Waldbott got involved with this topic in 1953 because of a cluster of strange illnesses among his allergic patients that were aligned with fluoridation. Yes, it isn't necessarily an allergy.... but he did skin tests on 2,000 people using 3 halogens (I believe chlorine, iodine and fluorine), and identified significant reactions associated with fluorine, albeit mostly not "allergic" but indicative of sensitivity or low tolerance to fluoride. He also did double blind studies. I only bring him up as a passing reference because of the consistent knee jerk reaction to associate fluoride opponents with the late 50s "communist conspiracy" craze, using that as an ad hominem attack to brush aside the scientific debate of the previous 15 years and that the NRC 2006 report and the NKF are tentatively admitting that there is sufficient indication that there are populations susceptible to adverse effect from low "optimal" doses of fluoride. That's the thrust here. It's not professional and not a neutral POV when Dr. Strangelove gets print but mention of Dr. Waldbott and Dr. Roholm is excluded. You can add Dr. Philip Sutton to that list, too. His objections beginning in 1957 to the faulty methods and erroneous data manipulation of those early studies has been validated by professional dental and medical organizations in recent years.
 * That the CDC & EPA in 2000 reversed their 50 year position that fluoride had to be ingested prior to tooth formation to be effective to saying its primarily topical and that care should be taken to NOT overdose children on fluoride in order to prevent fluorosis is significant. The NRC agrees that there is too much fluorosis due to too high an exposure to fluoride, plus worries about the health impact on other susceptible populations. The NKF officially withdrew its support on water fluoridation, adopting a "neutral" position, but actually saying that children and those with compromised kidney function or at risk of CKD should monitor their intake and discuss with their doctors.... plus there have been deaths associated with using fluoridated water in dialysis. BOTTOM LINE: The reversal in the consensus on how fluoride work and the mounting agreement concerning sub-populations susceptible to harm is, or should, be opening a scientific dialogue about this issue. It's not a "sides" thing.... it's an issue of changing context and emerging trends. Science changes... we think we "know" things only to be proven wrong, or find that things that used to work, no longer work. This article could use a little of that inserted. It doesn't need to be what I wrote, but it should be fair, balanced and reflect the current reality. Seabreezes1 (talk) 18:29, 4 October 2014 (UTC)

New US levels
On May 6th I added to the section on implementation "In 2015 the U.S. recommends fluoride be added to drinking water such that it contain no more than 0.7 mg/L (milligrams per liter, equivalent to parts per million). This was a change from a 1962"

On May 9th User:Prokaryotes added to the section on fluorosis "However, in April 2015, fluoride levels in the United States were lowered for the first time in 50 years, to the minimum recommended levels of 0.7ppm, because too much fluoride exposure has become a common issue for children teeth, visible in the form of white splotches. The basis were the results of two national surveys (1999–2004 NHANES) which assessed the prevalence of dental fluorosis, and found that two out of five adolescents had tooth streaking or spottiness on their teeth - an increase of mostly very mild or mild forms"

In summarized this as "In April 2015, recommended fluoride levels in the United States were changed to 0.7 ppm from 0.7-1.2 ppm to reduce the risk of dental fluorosis. In the US mild or very mild dental fluorosis has been reported in 20% of the population, moderate fluorosis in 2% and severe fluorosis in less than 1%"

Prokaryotes re added " for the first time in 50 years". That was already mentioned once in the article so I am not convinced it is needed a second time. Peoples thoughts? Doc James (talk · contribs · email) 21:26, 9 May 2015 (UTC)
 * I can't seem to find the mention in the article, can you point me to it, and this is the source i used, besides the official press release from CDC. http://www.theguardian.com/environment/2015/apr/27/fluoride-levels-us-drinking-water-lowered-splotchy-teeth prokaryotes (talk) 21:28, 9 May 2015 (UTC)
 * Ok i see now what you meant. prokaryotes (talk) 21:31, 9 May 2015 (UTC)

FA?
How can this be considered FA when it is so heavily spammed with US-centric content? Matthew Ferguson (talk) 17:50, 29 October 2015 (UTC)
 * You're welcome to add more international sources if you'd like. However I agree with the article's FA rating. Andrew327 18:41, 29 October 2015 (UTC)
 * Removing the excess of US-cenric sources is what is required here. Matthew Ferguson (talk) 20:18, 30 October 2015 (UTC)

This article reads like an advertisement for fluoridation, presents hypothesis and theory as fact
I just visited this page and was appalled at the review process. I'm fairly new to editing on wikipedia, and more used to peer-reviewed journals, but the present article is simply rife with apologetics and unsubstantiated assertions. If Wikipedia is to maintain its standards, this should be downgraded until it reads less like an advertisement.

example: "Most European countries have experienced substantial declines in tooth decay without its use, primarily due to the introduction of fluoride toothpaste in the 1970s" This is scientifically baseless, as it is statistically impossible to prove.

example: "Its use presents a conflict between the common good and individual rights."

The latter is a rhetorical form of "begging the question," assuming, as premise, that fluoridation is an overall "common good."

The list goes on. Wikibearwithme (talk) 06:06, 9 May 2015 (UTC)


 * There is a reference at the end of the "Most European countries" sentence, so the first step would be to examine that and see if the article is properly representing what the reference states. The second step would be to consider whether it satisfies the reliable source guideline. It's best to use plain language and stick to text in the article without too much emotion. Please see WP:SIGN. Johnuniq (talk) 04:04, 9 May 2015 (UTC)


 * What is "emotional" about "statistically impossible to prove"? The first step is to examine the statement on its merits.  A small introduction to statistics should settle quite well that nobody is proving this claim in any peer-reviewed journal.  I can cherry-pick off-hand remarks in otherwise solid research publications 'til the cows come home.  Using such as a basis for this type of assertion in an overview article is another thing altogether.  Wikibearwithme (talk) 06:05, 9 May 2015 (UTC)
 * Article talk pages are only useful for discussing the text in articles. Since you asked, here are some words/phrases which don't help: appalled, apologetics, unsubstantiated, advertisement, list goes on, introduction to statistics. I mentioned what needs to happen next. Johnuniq (talk) 07:58, 9 May 2015 (UTC)

Thank you for the input. I will attempt to not offend even the most delicate sensitivities.

However, back to the merits: I believe my points stand; and that, within the text of the article, I’ve pointed out well-recognized rhetorical devices dating back to the days of Aristotle.

When a human openly utilizes such rhetorical devices to publicly promote an industrialized process, as is prevalent in the present article, what term would you recommend as being more scientifically accurate and objective, relative to my chosen term, “advertisement” ? For example, the term “promote” is not adequately specific to commercial activity.Wikibearwithme (talk) 23:37, 3 June 2015 (UTC)
 * Wikipedia is about verifiability not truth. We just try to reflect the best available scientific literature. Doc James  (talk · contribs · email) 06:45, 4 June 2015 (UTC)

I agree with you that the page advertises fluoride Strawkipedia (talk) 05:37, 9 September 2015 (UTC)

Given what so far has been directed on the merits (as opposed to general observations), I believe my original points stand. Wikibearwithme (talk) 19:35, 5 November 2015 (UTC)

May not be neutral
Hello. I have noticed that this article may not have an NPOV(neutral point of view), so this article could be proposed for a non-npov banner as it supports fluoride.

Bye! Strawkipedia (talk) 09:01, 4 September 2015 (UTC)
 * Wikipedia articles reflect mainstream views based on sources we view as authoritive (like the U.S. Center for Disease Control, major national dental organizations). A lot of new readers are under the false impression that Wikipedia is gives weight to all views on a subject, but that is untrue. Otherwise we would be giving weight to all sorts of views that are not mainstream. --Smokefoot (talk) 13:01, 4 September 2015 (UTC)
 * Strawkipedia, thank you for coming to the Talk page with your concerns. Are there any specific sources you want included?  We'd be happy to review them here.  The current version of the article reflects the consensus of the medical community, but we are happy to consider any new information.  Andrew327 13:20, 4 September 2015 (UTC)

I am not saying Wikipedia needs to give weight to all issues, but maybe they could consider showing both sides of the issue(water fluoridation) and not just show supporting information? — Preceding unsigned comment added by Strawkipedia (talk • contribs) 22:12, 4 September 2015 (UTC)
 * Please read WP:GEVAL. We do not present both sides as if they are equal in any situation, but present the various positions with WP:DUE weight. In this case, all high quality medical sources state that water fluoridation is useful for preventing cavities. If you have any specific sources you wish to discuss, please bring them forward, though please be aware of our guideline on reliable sourcing for medical information before you suggest any. Yobol (talk) 22:27, 4 September 2015 (UTC)
 * After I read WP:GEVAL, I decided to think about my thoughts.

Maybe Wikipedia can not just show supporting info but also show conspiracy theories about fluoridation(not as if they're real!) That way, Wikipedia might be able to maintain a neutral tone (not that this isn't neutral). Besides, you only need to give weight to the main views. Strawkipedia (talk) 04:45, 5 September 2015 (UTC)
 * Links to Water fluoridation controversy are in place. Part of the problem is lack of reliable sources supporting the views of the conspiracy theorists, although the controversy itself is readily documented.  In fact the reason, conspiracy theories are called conspiracy theories is not because they are intrinsically weird or wrong, just that the theories are unsupported by decent references.  --Smokefoot (talk) 14:19, 5 September 2015 (UTC)


 * It appears that whenever some editor on WP  wants  to pour scorn on anything that offends their POV they quote due weight, main stream (main-stream by whom? ) etc. The York study (the only modern study that has yet been done) could only show a half tooth cary  reduction. Outside the US, there are counties that provide free or subsidised dental treatment for children. Therefore, cost of cosmetic tooth verniers cost many thousand over the life of an individual  who  develops dental fluorosis paid for by the states health system  which out weighs the cost of fluraidation..  So outside the US counties have been abandoning  the practice of fluoridating water as they discover it is based on bad science and pushes up their health care costs.  The Wikipedia project strives for a neutral point of view in its coverage of subjects. Read: Systemic bias. If some editors in the US feel frustrated that their POV/ strongly held beliefs, etc are  is not taken seriously then Go Figure. Ie, there is a lot of bad science  still swashing around on this article that the rest of the world has abandoned, which will be challenged time and time again on this article. Not out of any conspiracy of any kind  but out of a realisation that the original papers studies have turned out  not to be worth the paper they were written on. So to avoid systemic bias split the article into US views and other views. Doh!... Simple.--Aspro (talk) 16:54, 5 September 2015 (UTC)
 * The calmest way to deal with article improvement is to obtain great references from health professionals.
 * To digress into the observation that many countries are abandoning water fluoridation, which I think is true, that trend is potentially/partially related to the diminishing marginal benefits of water fluoridation since these populations are getting fluoride in other modalities such as toothpaste or fluoridated salt/milk/bread. It is also probably expensive to fluoridate. --Smokefoot (talk) 18:07, 5 September 2015 (UTC)


 * The calmest way to deal with article improvement is to obtain great references from scientists. Health practitioners may be competent at performing their skill but mostly, they can only parrot what they read in the poplar medical journals (who get extra finance from advertisements and patrons). So these publications are by no means neutral. So argumentum ad populum is a moot fallacy. Next we come to petitio principii or the fallicy of assuming the initial point (ie fluoride prevents caries). The connection with fluorides or lack of from any source has failed to materialize. In the UK we are addicted to drinking tea which is rich in fluoride but the incidence of caries didn't come down until the practice of good dental hygiene became common practice but as you should know negotiations is not proof of causation, yet people consuming high levels of fluoride still suffer caries . Pacific islanders with very low levels of fluoride appear to suffer no  caries at all. 80 year olds still have all their perfect teeth. I predict that  this article article will continue to fall short of the WP ideals,  whilst a  few vocal editors insist on their own ad verecundia  to maintain their Ownership of content by resorting to  fallacies to support their US centric POV position. This gentlmen is not WP is about. Split the article so that it appears to reasonable people as encyclopedic. --Aspro (talk) 19:37, 5 September 2015 (UTC)--Aspro (talk) 19:37, 5 September 2015 (UTC)
 * Cool, get those references from scientists or whomever. Probably not the place to argue about data, right? Because our opinions dont matter, only the references do. --Smokefoot (talk) 19:57, 5 September 2015 (UTC)


 * Right! References do matter. The 'York Review' (as I mentioned above) is a good place to start. To willingly ignore, is to be ignorant.--Aspro (talk) 23:54, 5 September 2015 (UTC)

O.K. Smokefoot, you got me when you said some people fluoridate bread, isns't that just like fluoridating water but in a solid form. And also, I really don't want any fluoride in my bread! — Preceding unsigned comment added by Strawkipedia (talk • contribs) 23:59, 5 September 2015 (UTC)
 * Well, some people dont want any iodide in their salt, but it helps prevent cretinism. And I dont like the taste of chlorine in my drinking water, but we have bacteria in the water supply here.  And toxic thiols makes our natural gas stink, but do-gooders put it in to help me notice leaks, or a little magnesium in my aluminium foil, but that alloy works better for wrapping our left overs, or tin in my PVC pipes used for sewerage, but Sn helps keep my pipes from cracking.  We live in a chemical world and a lot of people are dosing things we breath, eat, use... --Smokefoot (talk) 00:13, 6 September 2015 (UTC)


 * Oh Smokefoot, don't quite know how to put this. With my grandchildren and great nieces and nephews etc., its easy. They trust in me to dig them out the shit when they do anything that daft kids do at their age – oh, I have seen it all before -in fact, I often took the same naïve position myself at their age - so I recognize nonsense (that which makes no sense ) when I hear it.. `You are different, you have never met me nor know me from Adam. So can you watch this all the way through and ask afterward (after you have watched it all the way through) ''what has this video clip got to do with it?”). P.S.  Here is a List of fallacies to avoid in your answer.--Aspro (talk) 01:34, 6 September 2015 (UTC)


 * Okay, I've had enough argument! (Besides, Aspro's last comment is confusing) Should I put in the POV banner or not? — Preceding unsigned comment added by Strawkipedia (talk • contribs) 08:27, 10 September 2015 (UTC)
 * What is sought are WP:MEDRS. --Smokefoot (talk) 13:18, 10 September 2015 (UTC)
 * Are you even listening to me?! Why can't we agree on a conclusion? Strawkipedia (talk) 09:31, 30 October 2015 (UTC)


 * Because of Ownership_of_content. Escalate against this POV and the mass follows one there too. It is just a US thing regarding fluoridation. Most of the rest of the world has abandoned this  belief.. but in the US, their constitution uphold the right to believe in anything -even flying saucers.--Aspro (talk) 20:43, 30 October 2015 (UTC)


 * Let's just agree this article is good and not fight anymore. And these comments are getting very indented!(What are they called?) — Preceding unsigned comment added by Strawkipedia (talk • contribs) 06:12, 31 October 2015 (UTC)
 * Disclaimer: I am opposed to fluoridating water — Preceding unsigned comment added by 58.111.139.227 (talk) 08:57, 8 November 2015 (UTC)

Bauxite, Arkansas
No connection? "Mysteries at the Museum" seems to think so. :) 2001:56A:F414:D300:48F:52FF:529A:2B53 (talk) 03:31, 25 November 2015 (UTC)

Recent Kent statement as reported by the Guardian
I think this story is highly significant and well sourced. I would like to think that if it was to be removed as "probably not notable" this would be accompanied by some discussion. Let's begin. --John (talk) 15:09, 26 December 2015 (UTC)
 * Most editors often think that their favored sources are "highly significant", it's just human nature. For this reason biomedical articles tend to rely on what is called WP:MEDRS. --Smokefoot (talk) 16:02, 26 December 2015 (UTC)
 * Mmm. Also, why was the article misquoting the conclusions of this source? --John (talk) 16:10, 26 December 2015 (UTC)
 * The Guardian piece is drawing on this journal article, though its wording is much more circumspect: "In many areas of the world, hypothyroidism is a major health concern and in addition to other factors—such as iodine deficiency—fluoride exposure should be considered as a contributing factor. The findings of the study raise particular concerns about the validity of community fluoridation as a safe public health measure." As a scientist, Smokefoot understands that the mainstream media reports on scientific studies is often poor and exaggerated.  EdChem (talk) 16:12, 26 December 2015 (UTC)
 * But not in this case, eh? The report seems to have fairly summarised the study you quote. --John (talk) 16:14, 26 December 2015 (UTC)

Cochrane review
The Cochrane review is a very good source. It states "The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children."

We summarize it as "A 2015 Cochrane review found that water fluoridation was effective at reducing caries levels in children, but that most of the evidence for its effectiveness came from studies conducted before 1975"

It is saying that the evidence finds benefit but is old. We see this is a lot of areas of medicine. For example the evidence for ASA in MI is from the 1980s. Doc James (talk · contribs · email) 21:46, 26 December 2015 (UTC)
 * I see this as problematic, when the "Authors' conclusions" section includes language like "Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles." and "There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes." And from the "Quality of evidence" section "We assessed each study for the quality of the methods used and how thoroughly the results were reported. We had concerns about the methods used, or the reporting of the results, in the vast majority (97%) of the studies." I think the Guardian story reflects the source and its uncertainties better than the edit we currently have. Hence my edit, which was reverted. --John (talk) 21:53, 26 December 2015 (UTC)

Okay so this: But agree the evidence is tentative and added this. Doc James (talk · contribs · email) 22:14, 26 December 2015 (UTC)
 * "Our confidence in the size of the effect estimates is limited by the observational nature of the study designs"-> means it is not clear know how big of a difference it makes
 * "the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles" -> this means the evidence is not great
 * "There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes" -> it is not clear what would happen if fluoridation stopped
 * Indeed. And you think this is best summarised by "A 2015 Cochrane review found that water fluoridation was effective at reducing caries levels in children, but that most of the evidence for its effectiveness came from studies conducted before 1975." There is old, and there is poor, and I think it would be hard to escape the conclusion that Iheozor-Ejiofor Z et al. are saying these studies are not just old, they are both old and poor. Agreed? --John (talk) 22:17, 26 December 2015 (UTC)
 * Yes I think a good summary is "A 2015 Cochrane review found tentative evidence that water fluoridation was effective at reducing caries levels in children, but that most of the evidence came from studies conducted before 1975."
 * Just because the evidence is old does not discount it completely. I hope this is a reasonable compromise and do agree the evidence is less strong than we previously presented it. Doc James  (talk · contribs · email) 22:27, 26 December 2015 (UTC)
 * Thank you for the compromise. Here is the language from the original abstract: "Over 97% of the studies were at high risk of bias and there was substantial between-study variation." I was not suggesting discounting the source because it was old, but because it is poor. This recent study highlights just how poor, and this in turn has generated perfectly legitimate debate about the matter which is the subject of the article, as evidenced by the Guardian article. --John (talk) 22:34, 26 December 2015 (UTC)

Scotland
I remember this case very well. It marked the end of fluoridation in Scotland. Having found that the complainant's fears were unjustified on medical and dental grounds, and that fluoridation would likely bring benefits, "Lord Jauncey did, however, find against Strathclyde Regional Council on the sole ground that their statutory duty to provide "wholesome water" was insufficient to provide the legal powers for fluoridation."

About ten years ago it was again discussed at government level then rejected. It might be an interesting data point in the story about adoption versus non-adoption.

Overall, I think the article is somewhat biased towards the U.S. view of fluoridation being a public good, and gives too little credit to the European view that the resources are better spent on education. I'm also a little dubious about the "Water fluoridation prevents cavities in both children and adults." (my emphasis) in the lead, as I am not sure the current state of evidence supports saying this in Wikipedia's voice. More comments to come, no doubt as I properly read and digest the article. --John (talk) 00:20, 27 December 2015 (UTC)

Rather poor wording noticed after just the first couple of paragraphs
"Fluoridated water operates on tooth surfaces: in the mouth it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities."

Not sensible at all as this sentence implies that the effect might only occur whilst the water is in the mouth, fluoride is also ingested and works systemically (https://en.wikipedia.org/wiki/Fluoride_therapy).

"Water fluoridation prevents cavities in both children and adults,"

Wow, such a dumb thing to say, especially when immediately followed by:

"with studies estimating an 18–40% reduction in cavities when water fluoridation is used by children who already have access to toothpaste and other sources of fluoride"

Wouldn't "reduces" be more sensible?

Can't be bothered reading more, really poor form and should expect better from Wikipedia. — Preceding unsigned comment added by 121.44.18.150 (talk) 13:46, 15 January 2016 (UTC)

Heavely biased introduction.
This article is written under a US-centric point of view. The introductions labels fluoridation as a benefit as if it was a scientific consensus, but when we read the article we can clearly see this is far from the truth. Dornicke (talk) 16:47, 26 January 2016 (UTC)
 * Do you think it a good idea to work on another article where conspiracy theories are a large part? --Ronz (talk) 17:06, 26 January 2016 (UTC)
 * Several countries have abandoned fluoridation, so I don't think it's correct to label every kind of criticism as "conspiracy theories". The subject of fluoridation being benefical to health is simply not a scientific consensus among international community. So this article's tone should be changed. Dornicke (talk) 03:09, 28 January 2016 (UTC)
 * Now, if you're talking about fluoridation making people dumb or being used by nazis, yes, we could put that on an article about conspiracy theories. But the point about fluoridation being efficient, beneficial or harmless is not a consensus and is opposed not only by several countries but also 14 winners of the Nobel prize. I note there's a tendency in the US of misuse of the concept of "conspiracy theory" and this is starting to cause serious problems in this project. Not every kind of criticism to a majoritarian point of view is a conspiracy theory and should be disregarded, censored and ridiculed. This is a highly anti scientific behavior and certainly not how things are seen under a global point of view. Dornicke (talk) 03:18, 28 January 2016 (UTC)
 * The thing to do is bring good sources on the subject. A standard textbook of dentistry from advanced countries would be the way to go. Failing that, major reviews in a top journals.  The rules are spelled out in WP:MEDRS.  In terms of the benefits from fluoridation of drinking water, one relevant speculation, since that is what we are doing here, is that the marginal benefit to fluoridating drinking water is not so great because most people are using fluoridated toothpastes (I think).  Another problem with edits from some antifluoridation editors is that they often are not very scientifically literate, thus tend to bring up distractions or fail to understand basic chemistry like dose-effect relationships.  --Smokefoot (talk) 03:35, 28 January 2016 (UTC)


 * Agree with you. Anyway, this article reads like an advertising in favor of fluoridation. It can be called anything but neutral. Added bias tag. Dornicke (talk) 14:35, 28 January 2016 (UTC)
 * Just because you disagree with the gist of the article, does not mean that it is an advert. Otherwise, I would go tag every perspective that disagreed with my worldview.  So I am going to respectfully remove the tag.  If we find good sources that suggest that this article is off-base, then we could reimpose the tag.  --Smokefoot (talk) 14:45, 28 January 2016 (UTC)


 * The point is not the article disagreeing with my worldview - but the article presenting the benefits of fluoridation as if it was a consensus, when it isn't. The article falsifies reality. The second sentence, for example, says that "Fluoridated water has fluoride at a level that is effective for preventing cavities". But the article itself also says that "These standards are 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." Well, so you have to choose. Either you have "a level of fluoride" that is "effective for preventing cavities" or you have to admit that "there are not appropriate standards for the level of fluoride to be effective". You can't have both. This is just an example, the article is full of incoherences. So it has nothing to do with my worldview. It has to do with the editors that wrote this introduction presenting fluoridation as a consensual benefit, when we just need to read to article to see the introduction is a barefaced lie. I tagged it again. Dornicke (talk) 15:01, 28 January 2016 (UTC)
 * You will need to get consensus for that tag. Benefit of fluoride with respect to teeth among certain groups is fairly clear. Doc James  (talk · contribs · email) 16:22, 28 January 2016 (UTC)
 * No sources have been offered. Any forthcoming? --Ronz (talk) 18:07, 28 January 2016 (UTC)