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Fluoride Debate - An exercise in truth decay by Dr Don Mac Auley

We drink it every day without a moment´s thought. Soon we´ll be paying for it. But what price have we already paid for our drinking water over the last fifty years?

There is a growing belief that the chemical fluoride, added to our drinking water in Ireland since the 1960s to reduce tooth decay, has caused – and continues to cause – damage to both the health and the teeth of Irish citizens.
A cumulative poison, fluoride has been linked to hip fractures, reduced IQ in children, bone cancer and thyroid problems. The majority of European countries have tried fluoridation and stopped it. Some have gone as far as banning it.

As readers of Hot Press will know, Ireland is the only European country to mandate this mass-medication from central government and, as a result, we have the highest levels of fluoride-induced tooth damage in Europe. Called dental fluorosis, this damage manifests itself as white lines or pitting on the surface of teeth.

Dental fluorosis is the first sign of fluoride poisoning.

So, why is there no uproar? Why are people not marching the streets, demanding an end to this outrage?

Well, we did protest. Back in 2000, new international studies linking water fluoridation to serious health damage led to a nationwide campaign, with – as reported in the Irish Independent in June 2001 – 32 town and county councils voting to take the chemical out of Irish tap water.

Back then, dentists too, were complaining about the epidemic levels of dental fluorosis in children's teeth. Even the Minister of Health at the time, Micheál Martin's own Cork Corporation voted for an end to fluoridation in October 2001. This decision, however, was not theirs to make. Under the law, fluoride is centrally mandated. The only way it can be removed from the water supply is by a change in the law, meaning that the decision is in entirely in the hands of the Department of Health and the relevant Minister, currently a Junior Minister, Alex White.

In response to the wave of public concern, in May 2000, Martin set up the Forum on Fluoridation. It was heralded as an opportunity to “independently review the fluoridation of piped water supplies.” But what happened over the next two years is a chilling tale of cover-up, amounting to scientific fraud, when (a) a clique of researchers went to great lengths to defend existing public health policy instead of public health; and (b) the Food Safety Authority of Ireland changed minutes of meetings, buried a damning report and ultimately appeared to mislead the Dáil.

At the heart of it all are valuable research grants, where the same researchers received millions in tax-payers money as they continued to lobby to keep fluoride in our drinking water.

It is safe to suggest now that the real reason for the forum may have been to take the heat out of the situation and to provide a platform to undermine the anti-fluoride campaign. As is the case throughout this extraordinary story, the language used by Micheál Martin, in the press release issued by the Department of Health, gives the game away. "The Forum will perform a very valuable function in looking into all aspects of the fluoridation debate, answering concerns which the public may have…" he said.

The assumption from the outset therefore was that the concerns would be "answered". Lest there be any doubt about the Department and the Minister's position, at the start of what was supposed to be an independent review, he nailed his colours firmly to the fluoride mast.  "Fluoridation," the Minister continued, "has made a major contribution to the oral health of the Irish population over the last thirty seven years. Oral health gains have been made by children, adults and especially the socially deprived with a reduction in dental decay rates of 70%."

Clearly, the forum was never going to be the detailed health study required by law. That became even clearer when the membership of the Forum was announced: it was top-heavy with pro-fluoride “experts”, as analysed on the Fluoride Free website at the time. Many were government dentists or dental researchers who had already travelled the world promoting water fluoridation in other countries. Among these was Professor Denis O Mullane, the head of the Oral Health Services Research Centre at UCC. O Mullane describes himself as an “independent research worker” who has been studying, as he put it to the Oireachtas' Joint Committee on Health & Children in 2003,  “the effectiveness of water fluoridation for 32 years”.

Denis O Mullane - promoting fluoride in Ireland and abroad.

Every study carried out by O Mullane has supported his opinion that fluoridation is safe and more importantly cost-effective. The vast majority of Irish studies regarding fluoride have passed through O Mullane and his team in Cork. His track record is flawless: not one study from Europe, in countries without fluoridation which havebetter teeth than the Irish, that can't be explained away.What no one had figured, in their rush to rubber stamp the fluoridation of the Irish people, was that there were a few independent scientists on the Forum, interested in a genuine review. Dr. Wayne Anderson represented the Food Safety Authority of Ireland (FSAI), an organisation that holds a statutory responsibility for the safety of our food. After all, once you dump fluoride into the water you also contaminate any food that requires water in its preparation.

One in particular that uses fluoridated water drew interest from the FSAI: baby formula feed. Since 1994, a growing number of international studies had shown babies living in areas with water fluoridation were being overdosed with fluoride. These studies showed that, due to their large consumption of water in relation to their small size, infants were particularly sensitive to the chemical, showing worrying levels of fluoride poisoning – dental fluorosis.

Aware of these concerns, the FSAI commissioned Anderson and two other toxicologists to carry out a fluoride assessment on Irish infants under four months of age to see if there was a similar risk of damage here. Incredible as it seems, this was the first toxicological investigation of fluoridated water in the history of the Irish state. But, according to the records we have seen, Anderson didn't inform his dentist colleagues on the Forum of their work: there is no reference to the study in the minutes of the many meetings. Why? After all, it was groundbreaking research.

It was also the first fluoride study that hadn´t been carried out by dentists, nor had it passed through O Mullane in Cork. Could the FSAI have chosen not to inform the Forum, because they felt other researchers on the Forum would try and influence the independence and findings of their study? Either way, this is, indeed, exactly what did happen later, when the FSAI finally presented their 25-page report to the Forum on Fluoridation.

The toxicologists' conclusions in that report were genuinely shocking. Having accessed it under a Freedom of Information request, we can confirm that it states that bottle-fed infants were receiving up to seven times the safe dose of fluoride.

“Fluoride is a potentially hazardous substance that exhibits a wide range of health effects in man," it warned. "These range from mild effects such as mild dental fluorosis at low doses to severe acute toxic effects at high doses.” The toxicologists' concerns about the fluoride levels swallowed by babies went far beyond concern for their teeth. “It is also envisaged that doses of this magnitude could result in significant levels of skeletal fluorosis,” the report stated.

In other words, the water in Ireland, fluoridated by the Irish state,  could be causing bone damage in babies, when used to make up formula milk. At the Scientific Committee meeting of the FSAI on 3 October 2001, the minutes of which we have seen, the full board supported the position that, because of this new evidence, “infant formula should not be reconstituted with fluoridated tap water.” The FSAI scientific committee was clear: Irish tap water was not safe to make up babies' bottles.

However, there was no rush to inform the public. On the contrary, in what, in my view, amounts to scientific fraud, the FSAI subsequently buried the report and changed the minutes of meetings. What's more, their member on the Forum would later fail to inform the Dáil of everything he knew. The timeline of what happened presents a damning indictment of those charged with responsibility for public health in Ireland.

A week before the FSAI's Scientific Committee reached their original conclusions, the Forum on Fluoridation held its last meeting for which there are minutes. Everything was rosy and members were reminded that there were only two meetings left, on  October 18 and 25 respectively, before the Final Report would be presented to the Minister of Health at the end of October.

On 11 October, the FSAI findings were circulated to members. The mood changed dramatically: the Forum went into information shutdown. No minutes would be taken for the final two Forum meetings. This was a remarkable decision considering the Forum had been funded from the public purse and would decide on a policy that affected every Irish citizen.

What exactly the Forum discussed during these meetings we'll never know. But thanks to the Freedom of Information Act, we do know now what happened to the FSAI study and why it was never made public.

The reason we know this is that there was a third, top-secret meeting – a meeting that never took place, according to the website of the Forum on Water Fluoridation in Ireland. At this meeting, held on 23 October, the minutes from which we have accessed under the Freedom of Information Act, the same researchers who had spent their careers promoting fluorides were in the remarkable position of having to discuss an end to water fluoridation in Ireland.

The meeting had been organised by the Forum Chairman, Professor Patrick Fottrell, “to consider the implications” of the FSAI study on water fluoridation. Note the wording here: there was no question about the results. This was a meeting to plan the next move, given the FSAI's damning conclusions.

Among those in attendance was O Mullane, who had informed the Dáil the year before, “For over 30 years, I have conducted epidemiological studies in Ireland and overseas. A major focus of my work has been measuring the effectiveness of fluoride.”

The question might have been asked of O Mullane: if he had been so busy studying fluoride in his research centre in UCC, for more than three decades, why did he not know that bottle-fed infants were receiving unsafe amounts of fluoride from Irish tap water? After all, this was not new information – published studies hadhighlighted similar concerns dated back to 1994. Or – as elsewhere in this saga, is the clue to O Mullane's apparent lack of interest in fluoride damage betrayed by the language in his Dáil statement: “I have been measuring the effectiveness of water fluoridation for 32 years”?

If he had only been reviewing the positive effects of fluoridation, had he been ignoring the damage inflicted on those most vulnerable in society, as the FSAI states: Irish infants under four months of age, who have no teeth. Maybe O Mullane saw the toxicological report, agreed by nine independent Irish scientists, as the writing on the wall for a public health policy he had spent 32 years defending. That this is what was at stake is clarified in the minutes of the meeting, with the heading: “Stop Fluoridation or continue fluoridation.”
Another revelation from the meeting clarifies that the number of infants being damaged by fluoride was significant. “In 1998, there were 53,551 births," the minutes record, "therefore at any one time there will be a large cohort consuming infant formula… As the rate of breastfeeding in this country is extremely low, the number of infants receiving infant formula is considerable.” Reading the minutes you get the feeling there was a tug of war in progress: on the one side the pro-fluoride side questioning the study, while the others preach the importance of the precautionary principle.

We now know which side prevailed in the debate – but at what cost to the credibility of the FSAI? And more importantly, to the health of Irish babies?

The very next day the foregone was concluded. The possibility of causing bone damage in infants under four months old hadn't even given the Forum a bad night's sleep. On 24 October, the chairman of the Forum, Dr.Patrick Fottrell sent a confidential note stating that “The Forum recommends the continuation of fluoridation of public piped water supplies.”

The statement prepared by the Chairman and the Forum members, and handed to Christy Mannion for the Minister´s attention, amounts to scientific and medical negligence.
Not only had they ignored the scientific evidence, the Forum subsequently went on to pressurise the FSAI into withdrawing their study. Three days after the crucial, secret meeting Wayne Anderson, the FSAI´s representative on the Forum, wrote to the FSAI's own Scientific Committee explaining that they'd missed the deadline. “The risk assessment had to be withdrawn…" he added… "the document cannot now be re-submitted and there will be no mention of the risk assessment in the final report of the Forum to the Minister.”

Although Anderson apparently had buckled, at first the FSAI were not for turning. At the following meeting of the Subcommittee on Additives, Chemical Contaminants and Residues, on 30 Oct 2001, the FSAI again reiterated its position and “decided to adopt the precautionary principle in this matter”, confirming that infant formula not be made up with fluoridated tap water.

Later, according to reports in The Examiner at the time, the minutes of both these FSAI meetings would be changed and the FSAI study buried. The Forum delayed its report for another year while the Forum and FSAI debated the fluoride poisoning of Irish infants. And it all happened behind closed doors.

On 10 Sept 2002, the Forum finally published its recommendation  that the levels of fluoride in our tap water should be reduced. This also is extraordinary: in all of the public documents presented by the Forum there is not one reference to turning down the fluoride taps. It is only ever mentioned in the minutes of the top-secret meeting, during which the debate raged about what to do with formula fed infants. “It was found," the minutes note, "that while tighter control (of fluoridation) coupled with a lower target value of 0.6 to 0.8 mg would decrease the degree of overexposure it would not eliminate it completely.”

In other words, fluoridation will still cause damage to bottle-fed infants, just not as much.

Dr Wayne Anderson FSAI misled Dail?

The subsequent collusion between the FSAI and the Forum to keep this information from the public was staggering. In 2003, before the Oireachtas Health Committee, Dr Wayne Anderson completed the obfuscation. John Gormley (Green Party) asked Anderson: if the original report had not been changed would it have meant an end to water fluoridation in Ireland? His answer was this: “I do not know the full details of how that would have affected it, I would be speculating.”

It seems impossible to square that statement with the minutes, which confirm that Dr. Anderson was present at the top-secret meeting when Forum members discussed and debated an end to fluoridation on the back of a study he himself had presented two weeks earlier.

In 2007, the Minister for Health in the Fianna Fáil/PD coalition government, Mary Harney, finally acted on the Forum's primary recommendation to reduce the level of fluoride in our drinking water. This was all of six years after the FSAI study reported that formula fed infants were receiving SEVEN times the safe dose. Interestingly, three years earlier, in 2004, Micheál Martin actioned a lesser recommendation, when he set up the Irish expert body on fluorides and health; clearly, the “expert” body was more important than the health of Irish infants.

The familiar figures of Anderson, O Mullane and other pro-fluoride members of the Forum were predictably invited to participate in yet another quango paid for by the Irish tax-payer. This was not the only benefit for O Mullane: at the height of the storm over the infant formula in 2002, he received an award from fellow Corkman Martin of €500,000-€1,000,000 to conduct research into "the benefits and risks of water fluoridation."

Wading through the relevant documentation, it becomes ever clearer that what happened between the Forum and the Food Safety Authority regarding water fluoridation in Ireland is scandalous.

The way in which a report from the FSAI was subverted by the Forum on Fluoride surely has implications for the ethics and independence of scientific study in this country. But, more importantly it shows us fluoride health researchers prefer to protect policy than the most vulnerable in our society. This was the case in the 1960s when a group of dentists and the Fianna Fail government thought they knew better; and they still think they know better, even though international research increasingly links fluoride to serious health and teeth damage.

Mary Raftery, the journalist who exposed child abuse in church-run schools once posed the question – Do they think we're eejits? Regarding fluoride in our drinking water, the answer is yes. And next year they'll expect us eejits to pay for their poison – as if we haven't already paid enough.

Dr. Don Mac Auley.