Talk:Water fluoridation/Archive 3

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

Posted by John Chalos August 24, 2009 [email protected]

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

• Yes, that material was removed because it was a duplicate of a 2006 copyrighted opinion piece signed by Pete Chalos in the Terre Haute Tribune-Star. Wikipedia cannot accept copyrighted material like that.
• The above comments mischaracterize the 2006 National Academy of Sciences report, which explictly "does not examine the health risks or benefits of the artificially fluoridated water that millions of Americans drink".[2]
• Fringe sites like fluoridealert.org are not reliable sources for medical facts and figures; see
  WP:MEDRS
  .
• The letter from the EPA union does not appear to be notable, as nothing came of it. It was, if memory serves, led by a single antifluoridation member of the Washington DC local. However, if we can find reliable third-party sources establishing this letter's notability, it might be suitable for the
  Opposition to water fluoridation
  article.

Eubulides (talk) 23:12, 24 August 2009 (UTC)

Posted by John Chalos August 25, 2009 [email protected]

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

If you have a reference or citation to that 2005 congressional hearing, that would be worth adding to the

Opposition to water fluoridation article. The NAS study was entirely about water naturally fluoridated to levels well above those recommended for fluoridated water, and the study itself explicitly rejected the claim that the study was about water fluoridation; see, for example, page 20 of the study, which said "The committee is aware that some readers expect this report to make a determination about whether public drinking-water supplies should be fluoridated. That expectation goes beyond the committee’s charge. As noted above, the MCLG and SMCL are guidelines for areas where fluoride concentrations are naturally high."[3] Eubulides (talk

) 14:22, 25 August 2009 (UTC)

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

• The previous comment was evidently made by Rsauerheber (talk · contribs) without logging in. I'm not sure who its phrase "the person above" refers to. Rsauerheber, perhaps you could clarify? It would help to log in before posting, so that this sort of confusion could be avoided.
• The point about diabetics is evidently
  original research
  , and by policy can't appear in Wikipedia articles.
• Also, please read the policy page
  Wikipedia is not a soapbox
  . Following its device will help keep this thread on track. This talk page is for improving the article, not for serving as a general forum about water fluoridation. Off-topic threads are routinely deleted.

Eubulides (talk) 04:24, 1 September 2009 (UTC)

Understood.

1) Diabetic consumption data were published, reviewed by the National Research Council and re-published; it is not my original research.

2) There is total consensus that fluoride is NOT an essential element, because there is NO deficiency state that is reversed by the element alone that has ever been induced (The Merck Manual, 7th ed., 'Fluorine') This directly disproves the claim in 'fluoridation' that fluoride is added in a manner similar to that for iodide to reduce goiter. Such a claim is that of an extreme fringe minority who remain grossly mis-informed. If Wikipedia is interested in improving the article 'fluoridation', then at the very least could this false statement be deleted?

3) All artificial fluorides are listed on all poisons registries as rat poisons and insecticides (such as The Merck Manual 6th Ed., p. 2694; The Merck Index, 1976, etc.) while natural calcium fluoride is not listed on any poisons registry because its lethal dose is 30 times higher and is incapable of generating corrosive hydrofluoric acid HF in drinking water. The overfeed mentioned in 'fluoridation' used artificial sodium fluoride, which is 3,000 times more soluble (4.3 grams per 100 milliliters of water) than natural calcium fluoride (0.0015 grams per 100 milliliters). The poisoning of 300 people could not have happened if natural calcium fluoride (not a toxic compound below 5,000 grams per kg) were used for 'fluoridation' at 1 ppm. Natural calcium fluoride solubility prevents fluoride levels above 7 ppm fluoride in drinking water. Sodium fluoride and sodium fluorosilicate have lethal doses of a mere 0.125 grams per kg in tested animals, which compares to the lethality of arsenic.

The consensus viewpoint of the American people is against the artificial fluoride chemicals listed in the article 'fluoridation' that are injected into natural drinking waters, and in fact the people have voted more often than not against artificial fluoridation of water with these substances. They are widely used by water districts with support by city officials, rather than any perceived support of the people. (Nebraska state referendum voting data are on the public record, as are San Diego city voting data, but in most cases citizens are forbidden from voting on the procedure).

4) Teeth mottling according to scientific consensus is evidence of "consumption of too much fluoride" (Webster's 7th New Collegiate Dictionary), which is not a mineral nutrient in the first place (comment #2 above). Zipkin's studies published 1958 and recently reviewed proved that incorporation of fluoride sufficient to cause mottling of teeth already also caused incorporation of fluoride into bone that is irreversible (because calcium fluoride is so grossly insoluble) to thousands of times that above the level in fluoride water that caused such mottling. Accumulation progresses for the lifespan of the individual and the voting public should be given balanced credit for the choice and votes they have made. The article 'fluoridation' distorts the above 4 points of accepted fact.--Rsauerheber (talk) 05:41, 1 September 2009 (UTC)

For starters, please stop using spaces prior to your paragraphs - use the "Show Preview" button to see how your edits will turn out.

Secondly - exactly what changes do you propose to the article. All your paragraphs above are soapboxing and not helping the article.

Thirdly - the article states, The U.S. specifies the optimal level of fluoride to range from 0.7 to 1.2 mg/L (milligrams per liter, equivalent to parts per million), depending on the average maximum daily air temperature; the optimal level is lower in warmer climates, where people drink more water, and is higher in cooler climates.[31] The U.S. standard, adopted in 1962, is not appropriate for all parts of the world and is based on assumptions that have become obsolete with the rise of air conditioning and increased use of soft drinks, processed food, and other sources of fluorides. In 1994 a World Health Organization expert committee on fluoride use stated that 1.0 mg/L should be an absolute upper bound, even in cold climates, and that 0.5 mg/L may be an appropriate lower limit.[6] A 2007 Australian systematic review recommended a range from 0.6 to 1.1 mg - so your numbers are largely irrelevant in an article about Water Fluoridation and the dangers thereof.

Please cease with the soapboxing - start proposing where and what sections in the article you want changed, and your proposed changes. Shot info (talk) 05:51, 1 September 2009 (UTC)

I second this. Please propose specific changes to the article. What words would you change/add/remove and cite which reliable sources back up those changes. All the above is just soapboxing, wastes our time and will be deleted. Colin°^Talk 09:02, 1 September 2009 (UTC)

#1 'fluoridation' statement-- 'fluoride can occur naturally in water in concentrations well above recommended levels, which can have several long-term adverse effects, including severe dental fluorosis, skeletal fluorosis, and weakened bones.[42] The World Health Organization recommends a guideline maximum fluoride value of 1.5 mg/L as a level at which fluorosis should be minimal.[50]' Proposed addition: This guideline however does not take into account the high volume of water necesary for subgroups of people, such as with diabetes who consume the same fluoride daily dose from 1 ppm water as non-diabetic individualse drinking 2 ppm fluoride water. [note to editor: diabetic subgroups (and others with health conditions requiring high volume water consumption) were not identified and were instead merely averaged among populations examined in reviews such as that of York]. This fact also applies to the statement that fluoride does not affect bone strength and to the statement that if has no other adverse effects. These claims do no and have never applied to diabetics and other high water volume consumers. This is because biologic effects depend on the total amount consumed, not simply the 1 ppm concentration, as noted in a separate statement in 'fluoridation'].

T #2 statement-- 'the recommended level should not be below 0.5 ppm fluoride' correctly describes the decision made by the WHO, but it renders the false conclusion that water supplies with 0.2 ppm are somehow then deficient, and also that fluoride ia somehow a necessary mineral nutrient, when (as stated in the earlier post) it is not. The U.S. FDA and NRC both recognize that no condition (including dental disease) is associated with complete absence of fluoride. A qualifier is thus necessary to avoid presuming the WHO are alone experts on this topic. Millions of people have zero cavities for lifetimes in areas with water fluoride below 0.5 ppm. —Preceding unsigned comment added by 205.153.156.222 (talk) 19:56, 1 September 2009 (UTC)

#1 proposes text that does not cite any reliable sources, and thus fails the

verifiability policy. #2 does not propose any specific change to the article. Eubulides (talk

) 23:53, 1 September 2009 (UTC)

#1 references are numerous but one is: Greenburg, L., Nelsen, C. and Kramer, N., Pediatrics 54:320, 1974. is one of many references on the subject. These authors also recommended that diabetes insipidus, renal medullary disease, nephropathy patients, and most with solute diuresis are associated with such large water volume consumption that fluoride water levels considered acceptable for normal individuals would be sufficient to cause fluorosis symptoms over long term drinking. In studies with only 2 ppm fluoride for chronic periods suchindividuals defeloped abnormal bone X-rays due to incorporated fluoride.

The change I propose for #2 is a statement that 'fluoride is not a mineral nutrient, and no pathologic condition of any kind is associated with the absence of fluoride intake. The complete absence of fluoride in a human being is not an abnormal condition. Fluoridation of a human being is not a physiologic requirement for human health. The absence of fluoride does not cause dental caries. Caries are caused by consumption of sugary foods and not cleaing teeth afterward. [note: many references to these effects were already deleted from earlier posts]. Either fluoridation is explained well with proper context from both sides (knowledgable opponents vs. others who want it) or it will simply remain as is, with inferences a reader will make that are not true. —Preceding unsigned comment added by 205.153.156.222 (talk) 00:33, 2 September 2009 (UTC)

• Greenberg et al. 1974 (
  The Wikipedia guideline on medical sources
  says that case reports "are a form of anecdote and generally fall below the minimum requirements of reliable medical sources".
• No reliable sources have been given for #2.

Eubulides (talk) 03:53, 2 September 2009 (UTC)

If the better source mentioned (which is not referenced in the post) claims that people with diabetes insipidus drinking 1 ppm fluoride do not compare to people drinking 2 ppm, then that source, not matter how reliable Wikipedia considers it, is wrong.

Since 'fluoridation' is not going to make the corrections required, then the article cannot be recomended for any of my students, family or friends because it implies that all bone cancers in victims drinking 1 ppm water as source of fluoride were not caused by that fluoride; and that the U.S. FDA is incorrect in its position that fluoride is not a mineral nutrient and is uncontrolled use of a drug. Water fluoridation has never been approved by the FDA in spite of recommendations by the WHO. The FDA, not the WHO, is correct in their assessment.

It is unethical for anyone to presume the right to control an entry called 'fluoridation' in a public encyclopledia as though their written statements are all correct, and yet this is exactly what is being done under the auspices of Wikipedia. Good luck to you. --205.153.156.222 (talk) 23:19, 2 September 2009 (UTC)

The ariticle is only controlled (limited, if you will) by what can be backed up by published reliable sources. It may well be that we lack good quality sources on some of these issues and consequently the article suffers -- but that is the consequence of Wikipedia's policies. If the article was written by a named authority on the subject, and reviewed by other named authorities, such as might occur on Britannica, then we could leave it to those experts to judge whether to include one aspect or another, and whether to give a particlar case report or opinion weight or not. As Wikipedia can be written anonymously by anyone, we require all facts to be sourced elsewhere -- not to Wikipedian's own opinions, whether those opinions seem reasonable or not.

The issue that certain groups of people with illnesses that lead them to consume large quantities of water, and consequently are at greater risk of fluorosis, is a valid one. It is similar to the issues of setting the levels of fluoridation in hot countries vs temperate countries. If a reliable source can be found for this aspect it could be mentioned, but it must not be specified in a way that criticises the WHO guideline limits unless the reliable source also criticised the WHO guideline limits.

A statement something like "Fluoride is not an essential mineral nutrient and the absense of fluoride does not cause dental caries" seems a reasonable addition, provided a reliable source can be found for this. I think it would be useful to clarify that fluoride is not like certain other minerals that we require in our diet. However the statement "no pathologic condition of any kind is associated with the absence of fluoride intake" is not true -- caries is associated with lower/no fluoride intake, just not caused by it. The other points you suggest to add merely labour the point, and the causes of caries are more complex than just sugary snacks and insufficient brushing.

Colin°^Talk 14:31, 3 September 2009 (UTC)

Thanks for those helpful comments. Please see #Diabetes and #Essential nutrient below. Eubulides (talk) 19:16, 3 September 2009 (UTC)

For the topic of diabetes and water fluoridation, I searched the three best reviews we have on the safety of water fluoridation (the 2007 Australian review, Truman et al. 2002 (

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

"The U.S.

Institute of Medicine has established Dietary Reference Intakes

for fluoride: Adequate Intake values range from 0.01 mg/day for infants aged 6 months or less, to 4 mg/day for men aged 19 years and up; and the Tolerable Upper Intake Level is 0.10 mg/kg/day for infants and children through age 8 years, and 10 mg/day thereafter."

Institute of Medicine (1997). "Fluoride". Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academy Press. pp. 288–313.

ISBN 0-309-06350-7. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help

)

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

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

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

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

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

Water is a chemical, for goodness sake. A serious encyclopaedia doesn't adopt dumbed-down Daily Mail language. The insertion of "chemical" is clearly an attempt to introduce POV via the lay assumption that "chemicals" are nasty and to be avoided. Colin°^Talk 23:58, 8 September 2009 (UTC)

Fluoride is simply an element. The material added to the water is not simply an element. It is a compound chemical. I prefer the word chemical, but will settle for compound as a second choice. Petergkeyes (talk) 00:34, 9 September 2009 (UTC)

Why does this word need to be added? Shot info (talk) 00:38, 9 September 2009 (UTC)

Actually Peter, the location you have added it into is not needed. If you continue reading the paragraph you will see how the "addition of fluoride" is achieved. Likewise in the body of the article it is articulated more fully. The starting sentence how it was prior to your edit makes a nice neat summary of what "Water Fluoridation" actually is which is "Fluoridation of Water" by adding "fluoride" to "water". Shot info (talk) 00:43, 9 September 2009 (UTC)

For those who do not continue reading the paragraph, the first sentence is more accurate with the material identified. "Fluoride" is only a portion of what is added. It increases the accuracy to note the additive used, not just its targeted element. Petergkeyes (talk) 00:54, 9 September 2009 (UTC)

? Huh - increases accuracy? The first sentence is 100% accurate about Water Fluoridation prior to your edit - as the article is about ensuring fluoride is at a certain level in water - hence Water Fluoridation. BTW - have you read compound yet? Shot info (talk) 01:10, 9 September 2009 (UTC)

What is your argument, Shot? All of the additives used to fluoridate public water supplies are compound chemicals. Do we agree on that? 01:26, 9 September 2009 (UTC) —Preceding unsigned comment added by Petergkeyes (talk • contribs)

It's pretty easy to read what my argument - the article is about ensuring fluoride is at a certain level in water - hence Water Fluoridation. Shot info (talk) 03:22, 9 September 2009 (UTC)

• The cited source, CDC 2001 (
  WP:NPOV
  . Let's stick with the established terminology used by reliable mainstream sources on the subject.
• I again ask that potentially-controversial changes like these be proposed on the talk page first, not inserted unilaterally without discussion, as this change and this change were in the past three hours or so. Please see the top of this talk page.

Eubulides (talk) 03:53, 9 September 2009 (UTC)

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

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

Can you prove that brushing their teeth didn't prevent the cavities instead? People who drink fluoridated water but don't brush their teeth get cavities, while those who brush their teeth and drink bottled or distilled water do not. Dream Focus 16:22, 10 September 2009 (UTC)

The source in question (Glied & Neidell 2008 [PDF]) states that because the study is based on data from a time before fluoridated toothpaste and sealants became popular, its results can be ascribed to water fluoridation as opposed to fluoridated toothpaste or sealants.

Fluoridation #Economics does mention that the data were from 1957–1964; do you think that it should also mention that this predates fluoridated toothpaste and sealants? Eubulides (talk

) 17:40, 10 September 2009 (UTC)

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

PMID 18347661

.

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

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

"Fluoride is an

essential nutrient, but not in the most common sense as a precursor or cofactor of a metabolic pathway. Instead, like dietary fiber

, fluoride prevents a harmful biological process. In fluoride's case the harm comes from a modern lifestyle involving sugar and oral microbes, and diets lower in sugar remove the need for fluoride."

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

Eh, no. Fluoride has always been classified by nutritional science as "beneficial", not essential. To say otherwise is to misrepresent modern nutritional science and its classification scheme. For example, see the 2004 WHO draft paper on essential minerals in drinking water, page 12 (http://www.who.int/water_sanitation_health/dwq/en/nutoverview.pdf) which states that "the essentiality of fluoride for humans has not been proven unequivocally". I can also bring up my recent undergrad nutrition textbook, which states the exact same thing. Your research apparently completely missed the most key papers on this topic such as Tao and Suttie 1973. This is briefly reviewed in NRC 1989, which states that "these contradictory results do not justify a classification of fluoride as an essential nutrient". You say that these articles say that fluoride is essential - but you've got no quotes which say that exactly. Even your first quote is a roundabout way of proposing a nonmainstream (and highly illogical) view of what an essential nutrient is. Dietary fiber is not considered an essential nutrient either. II | (t - c) 19:53, 3 September 2009 (UTC)

I'm afraid that the sources listed in the previous comment are either out of date or not for citation.

• Tao & Suttie 1976 (
  PMID 939992
  ) is a 33-year-old primary source and is not reliable for the question as to whether fluoride is considered to be an essential nutrient now. Its contents make it clear that it's investigating whether fluoride is essential in the first (precursor-or-cofactor) way discussed by Jones & Varady, not whether fluoride is essential in the second (countering-deleterious-action) way. The proposed text addresses this point, by saying that fluoride is not essential in the first way.
• The NRC 1989 report is a reasonable source for how fluoride was considered twenty years ago, but the old notion of Recommended Dietary Allowance (RDA) has been superseded by the newer notion of Dietary Reference Intake (DRI). I just now checked the USDA website and the latest tables (dated 1997) generated by the NRC do list fluoride requirements. Bergman et al. 2009 summarizes the work of the Food and Nutrition Board’s DRI committee, which has been reviewing this standard, and makes it clear that fluoride requirements will also be in the next version of the standard.
• Given the above, I suspect that your nutrition textbook is relying on obsolete information; it wouldn't be the first time. But we could check this if you could supply the citation and quote from it, in particular, the sources that it cites to support its claims.
• That 2004 WHO draft is explicitly not for citation; do you have something else recent from the WHO that can be cited?
• "You say that these articles say that fluoride is essential - but you've got no quotes which say that exactly". Sure I do. The extended quote from Jones & Varady says "Furthermore, the actual function of an essential nutrient can vary categorically in at least two important ways. First,.... The second metabolic action of an essential nutrient exists through its countering the deleterious action of an independent biological process.... For example, fluoride acts to prevent dental cavities by interfering with the action of microbial destruction of tooth enamel." This clearly gives fluoride as an example of the 2nd category of essential nutrients.
• "Even your first quote is a roundabout way of proposing a nonmainstream (and highly illogical) view of what an essential nutrient is." Nope, it's the current mainstream. And there's nothing illogical about it.
• "Dietary fiber is not considered an essential nutrient either." It wasn't considered to be essential three decades ago, but it is now. For example, please see Gordon 2009, whose abstract begins, matter-of-factly, "Dietary fiber (DF) is an undefined nutrient, but an essential nutrient." That's just from a quick Google Scholar search of recent sources, but I'm sure more sources can be supplied.

Eubulides (talk) 20:55, 3 September 2009 (UTC)

The final citation to Olivares & Uauy is here. It says "the essentiality of fluoride for humans has not been proven unequivocally" (in fact, the weight is against it). Let's be clear about Jones & Varady: this is a speculative paper which proposes that plant sterols be considered essential because they are beneficial in reducing cholesterol. One could say the same about

statins. There are tons of nonessential substances which are well-tolerated and beneficial. Such a position would probably be characterized by Quackwatch as a CAM hype. It essentially ignores the traditional distinction between essential and beneficial nutrients, and its proposal will most likely be ignored because so many nonessential substances are beneficial. As you note, the NRC 1997 committee did come up with DRIs for fluoride (similar recommendations for fiber exist). A letter was mailed to the NAS about the lack of clarification. The response [4], by the President of the NAS and the President of the IOM, said "nowhere in the report is it stated that fluoride is an essential nutrient. If any speaker or panel member at the September 23rd workshop referred to fluoride as such, they misspoke. As was stated in Recommended Dietary Allowances 10th Edition, which we published in 1989: "These contradictory results do not justify a classification of fluoride as an essential element, according to accepted standards". Sometimes paper authors (even writing "reviews" OMG!) are able to sneak in opinions which don't really reflect mainstream "accepted standards". Sure, one can find numerous sources hyping dietary fiber who say it is an essential nutrient. But it's still not a traditional essential nutrient, and there are tons of Americans who live fairly happy lives on very little fiber. On the other hand, it's more like an essential nutrient than fluoride - one can be cavity-free quite easily without fluoride, whereas one will always be uncomfortable on the toilet without fiber. The old, traditional standards of nutrition are what should be used. And if an authority has not revised its statement, its original statement applies (as in the case of the NRC 1989). II | (t - c

) 21:57, 3 September 2009 (UTC)

• Thanks for the citation to Olivares & Uauy 2005. I agree that it is a better source.
• Although Jones & Varady is explicitly speculative about plant sterols, it is explicitly not speculative about fluoride or dietary fiber: it gives them as examples of essential nutrients of the "countering the deleterious action" type.
• Jones & Varady are not the only modern sources that use the more-expansive version of "essential" to mean "needed to promote optimum health" as opposed to "needed to survive". However, I agree that this use of the term is controversial among reliable sources, and that we should give greater weight to the consensus position. I'll propose a new draft in #Essential nutrient 2 below.

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

It is never as simple as you first think

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

• I did some more reading into the subject. It's quite a zoo. I looked for recent Google Scholar sources saying "fluoride is an essential nutrient" and found just one:
  • "Fluoride is an essential nutrient for the human body at low concentrations." (Tang et al. 2009,
    PMID 18329450
    ), a source I lack ready access to.
• Widening the search to the past twenty years found some lower-quality sources not worth mentioning, along with one moderated discussion, namely Fürst P (moderator) (2000). "Moderated discussion". Am J Clin Nutr. 71 (6 Suppl): 1688S–90S.
  PMID 10837317
  . It has this illuminating exchange:

Dr Harper

... What about fluoride? Is it a nutrient? A functional food? Is it just a natural product? We are not quite sure. Nevertheless, it is a substance that has an obvious and well-established beneficial health effect. I would separate the health effect from the pharmacologic effect. Thus, I might put protection of fluoride against tooth decay as a nonpharmacologic, but beneficial, health effect, and its effects at higher levels, in staining teeth or causing bone deterioration, as pharmacologic effects.

Dr Fernstrom

If it is not a nutrient per se, then that definition is not valid.

Dr Harper

That's the debate. We are not going to resolve it today, but some of us are not convinced that fluoride is an essential nutrient, yet we are convinced that it has a health effect.

Dr Fernstrom

Would you then call this, by definition, a pharmacologic effect?

Dr Hathcock

From a scientific viewpoint, it may not make much difference what we call it, but from a regulatory viewpoint, it is critically important. The definition can determine whether there is free access to a product or whether access will be by prescription only.

I also found another extremely dated source that talks about the controversy: Hegsted DM (1975). "Summary of the Conference on Nutrition in the Causation of Cancer". Cancer Res. 35: 3541–3. It says:

"There has been a long and continuing argument over whether fluoride is an essential nutrient, i.e., essential for life. This is a rather unproductive argument since the effect of fluoride on dental decay is obvious and its use in public health has nothing to do with our usual definition of essentiality. The fact is that it is essential for the maintenance of good dental health even though dental cavities might be avoided on low-fluoride diets if we could be nourished by by-passing the mouth."

This last comment essentially mirrors what Jones & Varady 2008 say in substance, even if it uses a different interpretation of the phrase "essential nutrient".

• I searched for "fluoride is not an essential nutrient" among recent articles, and found only two sources, both quite unreliable. Widening the search to the last 20 years found no more such sources.
• After further reading I'm inclined to think the following. First, the field of nutrition has to some extent (but certainly not completely) moved past debates about whether a nutrient is essential for survival, and toward more-complicated questions about whether a nutrient is needed for optimal health. Second, it'll take too much space to do this overall topic justice here, and any full details be in a different article. However, a brief summary would be helpful and I'll propose one in #Essential nutrient 2 below.

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

Essential nutrient 2

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

"Like

essential nutrient

, in the sense of being required to sustain life or growth in humans.^[2]"

References

1. Jones PJ, Varady KA (2008). "Are functional foods redefining nutritional requirements?" (PDF). Appl Physiol Nutr Metab. 33 (1): 118–23.
   PMID 18347661
   .
2. Olivares M, Uauy R (2005). "Essential nutrients in drinking water". Nutrients in Drinking Water. World Health Organization. pp. 41–60.
   ISBN 92-4-159398-9. {{cite book}}: |access-date= requires |url= (help); |format= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help
   )

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

Changed "prevents" to "acts against" as per discussion below. Eubulides (talk) 21:05, 9 September 2009 (UTC)

Looks good to me. Colin°^Talk 00:03, 9 September 2009 (UTC)

Fluoride doesn't fit the standard definition of a nutrient. The undergrad textbook I mentioned, Understanding Nutrition by Whitney & Rolfes (10th edition, 2005) defines nutrients as "chemical substances obtained from food and used in the body to provide energy, structural materials, and regulating agents to support growth, maintenance, and repair of the body's tissues ..." - on the same page (p. 6) they discuss "nonnutrients" which includes "fibers, phytochemicals, pigments, additives, alcohols, and others". The textbook definition is the one which most people intuitively believe, and it is also used in other scientific contexts (eg, the algal bloom was caused by excess nutrients). It is the one used in the lead of Wikipedia's nutrient article ("A nutrient is a chemical that an organism needs to live and grow or a substance used in an organism's metabolism which must be taken in from its environment"). If one defines a nutrient as anything which prevents a harmful biological process, all preventive drugs would be nutrients. Even devices could be defined as nutrients. Latex could be a nutrient for promiscuous young men; "in latex's case the harm comes from a modern lifestyle involving sex and genital microbes; monogamy reduces the need due to reduced promiscuity" (ingestion is not necessary for nutrient status - note vitamin D). Caffeine is nutrient that prevents the "harm coming from a modern lifestyle involving little sleep", and statins are the nutrient which prevents the "harm coming from the modern lifestyle involving too many cheeseburgers". Anyway, I don't like it and I think it's illogical, but I don't have a source stating my position. Obviously there are a lot of people who call fluoride a nutrient, so I guess I won't oppose the above couple sentences.

I will see about finding out what the graduate level textbook [http://www.amazon.com/Advanced-Nutrition-Human-Metabolism-James/dp/0534555217 Advanced Nutrition and Human Metabolism] says about the topic. It's a better source than a speculative 2009 Current Opinion paper proposing that functional foods be defined as essential nutrients, based on the already controversial and problematic precedent of fluoride and fiber. II | (t - c) 06:52, 9 September 2009 (UTC)

Although I agree that there is controversy among reliable sources whether fluoride is an essential nutrient, I don't see the same controversy over whether fluoride is a nutrient. Here are two examples I found with a quick search for "fluoride nutrient" in PubMed:

• "Food intake provides the necessary components for adequate metabolic functions in bone. Calcium, phosphorus, vitamin D, magnesium, proteins, and fluoride are some of the most important nutrients in this regard." —Vicente-Rodríguez et al. 2008 (
  PMID 18758899
  )
• "The set of updated standards is now called Recommended Energy and Nutrient Intakes (RENIs), defined as levels of intakes of energy and nutrients ... The desirable proportions of protein, fats, carbohydrates as well as fiber are also provided, in addition to information on recommended intake levels for selenium, magnesium, manganese, fluoride, cobalamin, and vitamin K." —Barba & Cabrera 2008 (
  PMID 18460438
  )

These are not speculative papers. Certainly fluoride falls into the category of substances that are "regulating agents to support growth, maintenance, and repair of the body's tissues" (in this case, dental enamel in the presence of sugar and microbes). Eubulides (talk) 07:15, 9 September 2009 (UTC)

Perhaps this is an area where a language-change is occurring wrt to the word "nutrient". Driven by the experts but the rest of us haven't caught up. I share II's gut feeling that it isn't a "proper" nutrient like we learned when I was at school :-). Colin°^Talk 19:36, 9 September 2009 (UTC)

No doubt it depends on which school you went to.... As this seems to be an argument about terminology rather than about the physical processes, how about if we make it clearer in the text that we are using the word "nutrient" in a particular sense? I modified the text as follows: "fluoride is a nutrient in the sense that it prevents a harmful biological process". I hope this helps to allay the concerns expressed above. Eubulides (talk) 19:52, 9 September 2009 (UTC)

No, don't do that. Do the sources say it is a "nutrient" but only in one sense? The article says fluoride repairs demineralisation with a tough veneer. That isn't just "prevents a harmful biological process" is it? If the expert consensus is that "nutrient" can be used wrt fluoride, without restriction/clarification, then we should be able to follow, even if some of our guts are unhapppy. Colin°^Talk 20:12, 9 September 2009 (UTC)

The source (which is the first quote in #Essential nutrient above) says that there are two categories of essential nutrients, and that fluoride is a nutrient in the second category. This is what I tried (apparently unsuccessfully) to render with the phrase "in the sense of". I agree with your gut reaction about terminology shift; that was why I tried to make it clear in the text that we are using the word "nutrient" in the sense that the source uses it. For now, though, I've reverted that change to the draft. Perhaps, now that you've seen the source, you can suggest better wording (or maybe that wording was OK)? Eubulides (talk) 20:20, 9 September 2009 (UTC)

The source says "counters the deletrious action of an independent biological process". "counters" isn't the same as "prevents" as the former includes repair. I'm struggling to come up with a replacement word for "prevents", however I'm less worried about the current text than the "in the sense that" text because the latter made "prevention" the only reason it was called a "nutrient". Currently, "prevention" is just an example of how it is "nutritious". Colin°^Talk 20:51, 9 September 2009 (UTC)

Thanks for catching both points. I changed "prevents" to "acts against"; that's a better synonym for "counters". Perhaps it's better to leave well enough alone about the "in the sense that" issue, as the following sentence makes it pretty clear that there is more than one nutrient category. Eubulides (talk) 21:05, 9 September 2009 (UTC)

As I mentioned, I'm not going to oppose the addition even though I don't agree with calling fluoride and fiber nutrients. So feel free to add it. II | (t - c) 22:57, 9 September 2009 (UTC)

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

I have undone this edit. I can't make sense of the edit summary ("removed reference to animals and "weasle words") as the edit didn't remove anything and added words rather than fixing "weasel words".

No, this edit reduced the sentence (paraphrased) "similarly there is an increase in levels of fluoride in the blood, and..." to "Similarly there is an increase in levels of fluoride in the blood.". Where there is mention of fluoridated water increasing levels of fluoride in the body, if a specific body area (saliva) is mentioned, then other specific body areas should also be mentioned. If no specific areas are mentioned, it should read "increased levels in the body". Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)

The previous comment incorrectly characterizes the edit in question. The edit didn't "reduce" the sentence: it inserted the sentence into the lead. The sentence does not summarize anything in the body (violating

WP:LEAD) and is supported by a poor-quality source. The edit also inserted some phrases not supported by the cited sources. Eubulides (talk

) 07:47, 16 October 2009 (UTC)

The assumption is that it by default will reduce tooth decay. Vaccines are used in an attempt to immunise against disease. Police speed checks are used in an attempt to reduce road fatalities. Water fluoridation can only ever be "in an attempt" to reduce tooth decay. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)

The introduction of "in an attempt" is an editorial comment that undermines what the cited source says. Let's stick with what the reliable source says. Eubulides (talk) 07:47, 16 October 2009 (UTC)

• The text removed "naturally occurring" wrt defluoridation. That was not helpful.

This article isn't about "naturally occurring" fluoridation. De-fluoridation has also been needed in non-naturally occurring water supplies. This should be corrected. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)

The cited source talks about defluoridation as "the lowering of the naturally occurring fluoride level in drinking water to prevent dental fluorosis". Water defluoridation is highly relevant to water fluoridation, as they have similar goals. Eubulides (talk) 07:47, 16 October 2009 (UTC)

• The text introduced the sentence "Similarly, it creates an increased level of fluoride in the blood." into the lead, sourced to a primary research paper. The WP article does talk about fluoride being absorbed into the blood and indeed deposited in the bones. It uses a better source. I don't quite know what "Similarly" is meant to imply as there's nothing similar about it. If we are going to cover systemic absorption of fluoride in the lead, we should use better sources and revise the wording and possibly position within the lead. For example, it is not clear to the reader why this should be relevant at this point. I think Eubulides should be able to suggest something here.

Colin°^Talk 16:28, 15 October 2009 (UTC)

I have undone this edit, which had the summary "Removed weasle words and restored impartiality to the section regarding "dental fluorosis"".

• The text removed the qualification on fluorosis: "most of this is mild and usually not considered to be of aesthetic or public-health concern". This qualification is supported by the source, which says "the majority of this fluorosis was mild and would not be considered to be of aesthetic concern." The "most" is not a weasel word here as it is equivalent to "majority of". The aesthetic concerns (or lack of) are not the opinions of pro-fluoride writers -- they are a result of questioning people (e.g. teenagers) on whether they regard the effects as of any aesthetic concern. One can't "restore impartiality" by removing bits of the text one doesn't like. If our sources say it generally isn't of aesthetic concern, then this can and should be reflected in our text.

Colin°^Talk 16:41, 15 October 2009 (UTC)

This uses biased, subjective language. Perhaps better wording would be "Surveys conducted suggest that most of this is mild and usually not considered to be of aesthetic or public-health concern" Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)

The cited source does not use this sort of qualification ("Surveys conducted suggest") and neither should this article. The word "considered" suffices in the source to indicate the obvious point that the esthetic judgment is subjective, and that wording suffices in this article too. Eubulides (talk) 07:47, 16 October 2009 (UTC)

I have undone this edit, which had the summary "Clarified the statement "has substantial advantages". Now specifically addresses the advantages.".

• The text replaced "Water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk." with "Water fluoridation, when feasible and culturally acceptable, can lead to a substantial decrease in tooth decay, especially for subgroups at high risk." This is not the point of the sentence. The point of the sentence, is that it has advantages over the other means of delivering fluoride or improving dental health, and those advantages are particularly seen in certain subgroups at high risk. Nobody needs reminding, at this stage, what the aim is ("a substantial decrease in tooth decay"). Colin°^Talk 18:22, 15 October 2009 (UTC)

This needs to be clarified in this case. It's ambiguous in its current wording. We should replace "has substantial advantages" with "has substantial advantages over other fluoridation methods".

The cited source, Petersen et al. 2004 (

PMID 15341615

) does not say "substantial advantages over other fluoridation methods"; it merely says "substantial advantages". In the context of the cited source it's clear that it is talking about other fluoride methods; that same context is present here, as the text in question is following the discussion of other fluoride methods. There's no need to add "over other fluoridation methods" here, just as there is no need in the source. 07:47, 16 October 2009 (UTC)

Colin, as Sandy has pointed out, there is a

WP:3RR rule. You might need to address this. Bitcloud1 (talk

) 23:21, 15 October 2009 (UTC)

WP:3RR says "A series of consecutive saved revert edits by one user with no intervening edits by another user counts as one revert." I chose to revert those changes bit-by-bit rather than revert back to an earlier version of the article. That was because I wanted to review and discuss each edit rather than just say "it was all bad". BTW: I follow a one-revert-rule. Colin°^Talk

08:13, 16 October 2009 (UTC)

(update) Hmm, I'd always understood

WP:3RR as warring against one party (or group of editors) over an issue. But the policy page doesn't restrict the reverts in that way, so several IP/newbie editors come along and add different sorts of nonsense (such as this poison-nerve-agent theory), I'm limited after the first revert. Oh, well. I guess we need more eyes on this article. Colin°^Talk

11:02, 16 October 2009 (UTC)

I undid this edit, which added material supported by a news article about a fluoride overfeed in Australia. This overfeed isn't particularly notable compared to the ones already mentioned (no injuries were reported, as opposed to the incidents already noted, which included many injuries and one fatality). It's better to use reliable secondary sources for material like this, to avoid problems with

I disagree with a 20 times over the limit fluoridation news article not being notable. Please revert this edit, or include this information in another way. Bitcloud1 (talk) 23:21, 15 October 2009 (UTC)

I respectfully but firmly disagree. There are countless public water supply systems in the world and some small percentage are almost always botching something. In my area we see spikes in chlorination. The acute

toxicity of fluoride indicates that it is grams per liter is when things get dangerous, not milligrams. The LD50 for sodium fluorosilicate in rats is 125 mg/kg (that's a big rat!, but seriously...) for a 50 kg person that LD50 translates to several grams per liter. So the incident in Brisbane is a non-event for most neutral readers (i.e., those neither for or against fluoridation). In fact, the absence of anything particularly bad happening with a spike in fluoride if anything, undermines some of the alarmist rhetoric on this page. --Smokefoot (talk

) 00:01, 16 October 2009 (UTC)

Perhaps a subpage or subcategory of "incidents of accidental over fluoridation" should be made rather than just ignoring these news items. It was a national news item. Your comments lead me to believe that it may be a commonly reported occurrence, in which case it definitely needs to be addressed. If the other illnesses are a result of negligence in fluoridation, then all incidences of negligence are notable. Bitcloud1 (talk) 02:02, 16 October 2009 (UTC)

That sort of material would be

original research in this article, and can't appear here. Eubulides (talk

) 07:47, 16 October 2009 (UTC)

Wikipedia is an encyclopaedia, not a collection of bad-news stories. It is a very poor and unfair way of conducting an argument to list all the bad things one can find. Naturally, the press covers bad news. Nobody writes/reads news stories like "Wee Jonny went to the dentist for a checkup and didn't require any fillings." So such an article or set of articles would be perceived as a

WP:NPOV by seeking to cast a topic solely in a bad light. Colin°^Talk

08:13, 16 October 2009 (UTC)

"justified" section. Why does this belong in the lead? Citation is a subjective work, and includes the subjective terms "may be". I don't feel this is appropriate for the lead. Bitcloud1 (talk) 23:36, 15 October 2009 (UTC)

The cited source, Burt & Tomar 2007 (

ISBN 0195150694), is high-quality expert opinion, and the opinion is properly qualified with a "may be" here. The sentence in question is extremely helpful in the lead, as it ties together the previous sentences' coverages of alternative fluoride methods and of different experiences in U.S. and Europe. No reliable sources disagree with the claim in question. Eubulides (talk

) 07:47, 16 October 2009 (UTC)

A recent edit by the new user

A recent edit inserted the following text:

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

citing the following sources:

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

These sources do not support the claim in question: they do not say "Even though it it widely endorsed, various scientific studies have found". The claim in question is therefore

This sentence leading the Effectiveness section is vague to the point of being useless and just looks like fluoride promotion. The statement is not event supported by its citation. —Preceding unsigned comment added by Gregwebs (talk • contribs) 02:58, 14 October 2009 (UTC)

It looks like a straightforward statement of fact to me, particularly as the introductory sentence to a section on "Effectiveness". The source cited states:

Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries (i.e., tooth decay) in the United States and other economically developed countries. When used appropriately, fluoride is both safe and effective in preventing and controlling dental caries.

Perhaps it would be helpful if you could indicate which part(s) of the sentence you have problems with?

• Fluoride's contribution to dental health?
• The contribution to children's dental health?
• The contribution to adults' dental health?
• The contribution to dental health in many countries?

I think that when you define your objections, you'll see that the sources in the article actually do support the sentence. --RexxS (talk) 03:34, 14 October 2009 (UTC)

Objections:

WP:NPOV

, mixes concepts

• The statement is about "Fluoride" instead of "Water fluoridation"
• The vagueness of "worldwide"
• The vagueness of "has contributed"
• The interjection of the word "children"
• The statement being made factual instead of attributed

This section is supposed to be about the effectiveness of water fluoridation, not about how wonderful fluoride is for our children. —Preceding unsigned comment added by Gregwebs (talk • contribs) 03:58, 14 October 2009 (UTC)

The section does need a lead; we can't simply remove the sentence and leave a gap. It would make sense to make the sentence more specific about water fluoridation. How about replacing the lead with "Water fluoridation reduces tooth decay in children and adults."? That's short and sweet and summarizes the section nicely. The cited source makes a clear distinction between children and adults, so our text should too. The sentence should be attributed in the usual way with a footnote, not with in-text attribution, because in-text attribution would incorrectly convey to the reader the impression that the claim is controversial among reliable sources. Eubulides (talk) 06:22, 14 October 2009 (UTC)

Indeed, this lead sentence would be more useful if it specified "water fluoridation" vs just "fluoride." Other sentences in the same paragraph also could be improved as indicated by my {inserts}: "Moderate-quality research {sounds like an attempt to placate a complaining group}} exists as to water fluoridation's effectiveness {for what?, dental health one assumes, isn't that the point of the whole article and the reason that the US CDC lists fluoridation of water as a top ten advance?}"--Smokefoot (talk) 12:54, 14 October 2009 (UTC)

The suggested intro is better, but still not specific enough. "Water fluoridation reduces tooth decay in those whose teeth do not regularly come in contact with fluoride." Gregwebs (talk) 15:31, 14 October 2009 (UTC)

That's circular. With water fluoridation their teeth will regularly come in contact with fluoride. Colin°^Talk 15:37, 14 October 2009 (UTC)

"... teeth do not *otherwise* regularly ...". Reliable sources used in this article show that in Europe, where there is no water fluoridation, they have reduced tooth decay. These sources attribute it in large part to other sources of fluoride, such as fluoridated toothpaste. Water Fluoridation would have been of little benefit to them, just as it is of little benefit to anyone who already has adequate fluoride exposure. —Preceding unsigned comment added by Gregwebs (talk • contribs) 16:00, 14 October 2009 (UTC)

The claim "Water fluoridation reduces tooth decay in those whose teeth do not otherwise regularly come in contact with fluoride." is not directly supported by the cited source, so we can't use that wording. Furthermore, the wording clearly implies that fluoridation does not reduce tooth decay in those who brush with fluoride toothpaste regularly, an implication that is incorrect. Let's leave the topic sentence short, sweet, and a summary of the section, rather than introduce unsupported (and incorrect) editorial opinion. Eubulides (talk) 06:50, 15 October 2009 (UTC)

This is directly supported by citations in the article "Community water fluoridation and caries prevention: a critical review" PubMed 17333303: "...the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread... studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention particularly in the industrialized countries where the caries level has became low."

This major point about the effectiveness of water fluoridation should be in the introductory statements to maintain accuracy and a NPOV. —Preceding unsigned comment added by Gregwebs (talk • contribs) 03:55, 17 October 2009 (UTC)

"This is directly supported by citations in the article" No, those quotes from Pizzo et al. 2007 (

WP:WEIGHT problem in featuring them much more than they're already featured. But perhaps, if you think this part of their argument is crucial, it could replace some of the existing text. Eubulides (talk

) 06:27, 17 October 2009 (UTC)

I do think for this section titled "effectiveness" the fact that the effectiveness greatly varies if there are other methods of fluoride exposure needs to be clearly stated and reflected in the introductory remarks. —Preceding unsigned comment added by Gregwebs (talk • contribs) 20:16, 17 October 2009 (UTC)

The Effectiveness section already does what you're requesting. Its second sentence says the effectiveness of water fluoridation has gone down significantly with time, likely due to the introduction of fluoride toothpaste, plus the halo effect. Eubulides (talk) 07:37, 19 October 2009 (UTC)

Ok, I was in the mindframe of only thinking about an intro sentence, not an intro paragraph. If we remove the first sentence that doesn't add useful information, then we will have a good intro paragraph that goes over the historical effectiveness of water fluoridation and makes very specific statements with useful information. Gregwebs (talk) 23:52, 19 October 2009 (UTC)

The previous discussions on this subject were interesting, but based on original research of what an essential nutrient is. None of the cited sources state that fluoride is an essential nutrient. WP does not list it as

The coverage that's currently in

PMID 18347661), which provide dietary fiber as helpful example of another nutrient that has beneficial effects but is not essential. This discussion is highly relevant to fluoride and is well supported by reliable sources, with no serious dispute about it in reliable sources; I see no reason to remove the discussion, though of course there is always room for improvement in the coverage of any topic. Eubulides (talk

) 05:06, 12 October 2009 (UTC)