Talk:Water fluoridation/Archive 11

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Blatant pro-fluoridation bias

Rather than describing the many arguments against fluoridation raised by opponents, the editors of this article use the ploy of focusing on one straw argument and claiming that those who raise the argument are non-scientists on the political fringes of society. The article needs to cover the arguments raised by educated people, including doctors and scientists. Moreover, the fact that fluoridation is controversial needs to be in the opening paragraph. Floride is a known neurotoxin, why isn't this mentioned? No studies for side effects are considered reliable, and that is considered an argument IN FAVOR of fluoridation??? Why no mention of the industry lobby? Jdkag (talk) 19:56, 20 March 2016 (UTC)

Hello @Jdkag:. What specific change to the article are you proposing? And what sources are you citing to back up that change? --McSly (talk) 20:17, 20 March 2016 (UTC)

You should review WP:FRINGE. The bias you see may just be the proper application of FRINGE and NPOV. --Ronz (talk) 20:22, 20 March 2016 (UTC)

Have restored content supported by a 2001 and 2009 review which is not 25 years ago. Doc James (talk · contribs · email) 21:19, 20 March 2016 (UTC)

The reference is this: "Initial studies of community water fluoridation demonstrated that reductions in childhood dental caries attributable to fluoridation were approximately 50%--60% (94--97). More recent estimates are lower --- 18%--40% (98,99)." The studies 98 and 99 are from 1990 and 1989 respectively. Doc James, I see that you are quick to undo and to make claims without checking. Does this page belong to you?Jdkag (talk) 21:26, 20 March 2016 (UTC)

Proponents of fluoridation would like to see the argument framed as one between "the common good" and "individual rights". The vast majority of opponents do not see any "common good" in adding a toxin to the water supply when there is no evidence that the toxin improves dental health for a society that brushes. In other words, the safety issue is far more substantial in the eyes of most opponents than the individual rights issue, with the second major concern being the financial issue (i.e., seeing no reason to spend money when at best there is no benefit). A book by a staunch fluoridation proponent is not a valid source for the views of opponents. Concerns of opponents are available on the following sites. (The fluoridation lobby has "blacklisted" the full urls from Wikipedia) : momsagainstfluoridation, fluoridealert, nofluoride. Jdkag (talk) 22:05, 20 March 2016 (UTC)

No the reference is this review from 2001.[1] One does not use the sources a 2001 review uses to determine the year of the reference in question.

Remember bold revert discuss. Now is the time to get consensus. Doc James (talk · contribs · email) 22:12, 20 March 2016 (UTC)

Doc James, early studies showed that fluoridation reduced caries by 50-60%. A 1989 study then claimed that the reduction was 40%, and a 1990 study showed that it was 18%. Those studies were reported by the CDC in 2001 (which used that 2001 study to justify its current support of fluoridation). But recent surveys (2007) indicate that fluoridation may provide no reduction, given that people use fluoride toothpaste. If you want to rewrite the sentence to indicate that surveys over time show a declining need for fluoridation, that would be most accurate.Jdkag (talk) 22:50, 20 March 2016 (UTC)

We are looking for recent reviews not recent surveys. Doc James (talk · contribs · email) 00:12, 21 March 2016 (UTC)

agree w/ DocJames (One does not use the sources a 2001 review uses to determine the year of the reference in question.)--Ozzie10aaaa (talk) 23:20, 20 March 2016 (UTC)

The whole section on ethics is brazenly non-NPOV. Tens of scientific studies have shown a link between lower IQ and fluoridation, but all the studies have had some faults. That is, no conclusive study has been conducted despite the hundreds of millions of subjects that have been available for decades. Administration of a toxin despite the lack of proper studies is unethical, and the lack of careful studies (not only for IQ) supports the contention by opponents that fluoridation is supported by a strong lobby that does not have the public's best interest at heart. The recent New Zealand study that claims that fluoridation does not affect IQ in fact merely shows that IQ is not noticeably different between people who get fluoride from water or from toothpaste or from tablets. (The bias of the authors was obvious from the fact that they did not bother to publish whether there was any difference in dental health between the groups, as there likely was none, meaning that fluoridation was unnecessary.) In any case, 94% of the world's population does not drink water that has been artificially fluoridated, meaning that opposition does not come from a "fringe" segment of the population, but rather that supporters are the "fringe".Jdkag (talk) 22:51, 20 March 2016 (UTC)

Jdkag: operationally one's views are automatically classified as fringe if one asserts or implies that the CDC is misleading the populace of the world's most technologically advanced country. --Smokefoot (talk) 23:51, 20 March 2016 (UTC)

The article provides a balanced description of both viewpoints. The negative viewpoint is well-characterized in the "Ethics and politics" section. Axl ¤ [Talk] 11:47, 21 March 2016 (UTC)

"94% of the world's population does not drink water that has been artificially fluoridated, meaning that opposition does not come from a "fringe" segment of the population, but rather that supporters are the "fringe"." That's not what "fringe" means. If 94% of the world's population believe that fluoridation is harmful, then the supporters would be fringe. Axl ¤ [Talk] 11:52, 21 March 2016 (UTC)

Thanks for pointing out those data. We are talking about "authority" From Wikipedia:Fringe theories: "Scholarly opinion is generally the most authoritative source to identify the mainstream view." For the well-being of the populace, the CDC speaks with greater authority than any fraction or majority of the population. If authority were defined by the majority of the population, in my country (U.S.) we'd be teaching creationism etc in schools. So getting back to the assertion of pro-fluoridation bias, the way to go after this is to find sources from major dental textbooks or related WP:MEDRS venues.--Smokefoot (talk) 13:17, 21 March 2016 (UTC)

If 94% of the world's population believe a particular statement, then that particular statement is the mainstream view, irrespective of what the CDC or any other body says. My point above is that the absence of water fluoridation does not demonstrate a mainstream belief of inefficacy.

By the way, creationism is taught in US schools. Axl ¤ [Talk] 14:03, 21 March 2016 (UTC)

Re this comment: "If 94% of the world's population believe a particular statement, then that particular statement is the mainstream view" Two points: First with regards to water fluoridation, we dont know what these 94% "believe". Second, if the majority of people had an opinion that differs from professionals, the professionals have sway and are defined as mainstream, at least according to my reading of Wikipedia policy. In other words, if most people think that humans were created 10,000 years ago, but biologists say otherwise, the biologists have sway, and the majority are said to adhere to a fringe theory. --Smokefoot (talk) 15:26, 21 March 2016 (UTC)

"with regards to water fluoridation, we dont know what these 94% "believe"." Indeed!

Regarding your second point, I disagree. There is a technical difference between "mainstream view" and "mainstream science". The former refers to the whole population while the latter is specific to the scientific community. Usually the two viewpoints are the same, if for no other reason than that most non-scientific people have not evaluated evidence for different possible views. Wikipedia's guideline does not address situations where the popular mainstream view is contrary to the mainstream scientific view. (I am not sure that there are any real-world situations where that applies.) Moderately popular fringe theories such as intelligent design and holocaust denial are mentioned. Axl ¤ [Talk] 16:21, 21 March 2016 (UTC)

Hi Axl, Thanks for the note. Maybe we are taking this discussion off onto a philosophical tangent, so I'll sign off for now. Cheers, --Smokefoot (talk) 18:02, 21 March 2016 (UTC)

Editors worry too much about Wikipedia's "accuracy". Everyone knows it is US centric definitive, wrdy social engineering and constantly expresses discrepencies between "worded" descriptions and actual reality. Anyrate, keep drinking that water regardless. It's for your own good, they say. — Preceding unsigned comment added by 219.79.52.87 (talk) 04:23, 22 March 2016 (UTC)

The vast majority of anti water fluoridation sources are generated in USA. Matthew Ferguson (talk) 08:10, 22 March 2016 (UTC)

To be fair, water fluoridation is not so common in Europe where such opposition might arise; the article notes that tooth decay rates remained stable in that region after water fluoridation ended. Overall, the article is quite fair to the negative position. II | (t - c) 06:21, 23 March 2016 (UTC)

The likely reason that decay rates in Europe are stable after the fluoridation ended is that people are getting fluoride through toothpaste. It would be interesting to see how pervasive are fluoridated toothpastes.--Smokefoot (talk) 12:47, 23 March 2016 (UTC)

Smokefoot has a point. Just because someone went to medical school a long time ago and got some qualifications decades ago, should not blind them to the fact that science moves on and what they were taught was only to get them though the med exams. In other words they should have been made aware (or be aware) that what they where being taught was not gospel in every sense. Just as modern CPR is a lot different from what was taught earlier -and thus more more people survive when the modern CPR protocol is practised. They must keep up-to-date with advancements in knowledge. Just as in the second world war, much advance was made in treating air crew rescued from cold seas (their sorties from Britain to Germany and back took them over the the very cold North Sea) and were suffering hypothermia. They where often rescued alive OK but quickly died. But by abandoning the then medical orthodoxy view and applying modern science, it saved many an and American air crew. American Science beliefs should not preserved in aspic. It goes against, and flies in in the face of Americanism. So I agree whole heartedly with smakefoot. This article is a blatant example of Wikipedia:Systemic bias. A solution would be to split it 'explicitly' into two parts. One featuring the US beliefs and two: the rest of the worlds views. Just as Smokefoot wondered about the supposed benefits of toothpaste, the almighty publication Nature (a very conservative and strictly peer reviewed journal) published The mystery of declining tooth decay which too casts doubts about toothpaste. Medical science and knowledge advances all the time and we should not allow ourselves to be left behind with old beliefs that don't past muster in the modern age .--Aspro (talk) 19:06, 23 March 2016 (UTC)

Sorry, but what is the point you feel justifies such a division? It might be best to find a reliable source to support it so it doesn't look like original research. --Ronz (talk) 21:34, 23 March 2016 (UTC)

Effectiveness

Fact: "Studies have shown that water fluoridation effectively reduces cavities in both children and adults." However, because the studies are old and many were poorly conducted, we cannot conclude that "Water fluoridation effectively reduces cavities in both children and adults." The first sentence of the section should not make a contention that is not supported by the body of the text.Jdkag (talk) 10:06, 26 March 2016 (UTC)

New reviews continue to repeat the conclusions of the older studies. Doc James (talk · contribs · email) 15:09, 26 March 2016 (UTC)

Griffin 2007 vs. Cochrane

The Cochrane report specifically counters the validity of the Griffin conclusions, and the conflict between the two should be indicated in the wiki entry: "Griffin 2007 undertook a comprehensive systematic review evaluating the effectiveness of fluoride in preventing caries in adults, including nine studies that examined the effectiveness of water fluoridation. The studies included fell outside the scope of both the McDonagh 2000 review and our review.... The fluoride concentration evaluated in these more recent studies was not reported in two studies and was above what is considered the 'optimal level' in a further two studies. Griffin and colleagues acknowledge that the paucity of studies and the quality of the included studies limits their review."Jdkag (talk) 13:59, 26 March 2016 (UTC)

Different reviews use different criteria for included trials. That does not mean one counters the other. Doc James (talk · contribs · email) 15:13, 26 March 2016 (UTC)

The British Fluoridation Society = RS?

Some stock is placed in this august-sounding group "The British Fluoridation Society". http://www.bfsweb.org/about/aboutus.htm Editors consider it a reliable source? --Smokefoot (talk) 13:47, 26 March 2016 (UTC)

It depends for what. Not for medical content but okay for social and culture discussions maybe. Doc James (talk · contribs · email) 15:16, 26 March 2016 (UTC)

Iodine and flouride

There is some evidence that fluoride being more electronegative than iodine can interfere with thyroid function when consumed in hogh concentrations or when an individual is already iodine deficent. Perhaps this should be mentioned in safety? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890436/

As a scientist, there's a lot about that paper to make me twitchy. (Curiously-chosen groupings for analysis, smallish sample sizes, no presentation of raw data, new and iffy journal, etc.) As a Wikipedia editor, I'll just say that it's a primary paper, not yet independently corroborated, and therefore generally inappropriate as a source for medical information or claims. There's also no indication that there is an effect at fluoride concentrations close to the recommended levels for artificial water fluoridation (the high-fluoride groups were exposed to water containing natural fluoride in significant excess of the recommended doses.) TenOfAllTrades(talk) 03:34, 5 April 2016 (UTC)

After further review I agree that claims of thyroid impairment by fluoride are dubious. Thanks for your skepticism and input. [2] — Preceding unsigned comment added by 208.90.213.186 (talk) 21:21, 8 April 2016 (UTC)

New addition to the lead

Am moving this here

"While health organizations such as the World Health Organization , the FDI World Dental Federation, Centers for Disease Control and Prevention and many others have endorsed water fluoridation for many years, the practice is still controversial as a public health measure. Major systematic reviews (York 2001, NRC 2006, Cochrane 2015) cited their surprise on the absence of high quality research for the benefit and potential harm of water fluoridation, leading the chair of the nrc review to comment in 2008 on the controversy itself: "But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on. I think that’s why fluoridation is still being challenged so many years after it began. In the face of ignorance, controversy is rampant.”"

References

It still needs work and the refs need formatting. Which ref applies to which parts for example. Doc James (talk · contribs · email) 18:35, 9 April 2016 (UTC)

You haven't read the York Review have you! The lead of this study found himself having to publish a statement re-emphasising what the review actually found. Its here: Fluoridation Statement

:Quote:“We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. “ unquote.

The whole reason many meds where removed from OTC in the 1950's was that it was thought that qualified people would not be taken in by the hype of popular opinion and proscribe & advise but instead - form opinions themselves from studying the best current research available.

I was the first editor to reference York Review here (see history) because I had read every word! I do my research, but since then, it has been mangled by those that just reiterate the diatribe from med journalists who cherry pick. So I trust you wont take affront but understand why I am reverting your edit to one that better reflects larger current world view. A bit of polishing can be done later.--Aspro (talk) 20:37, 9 April 2016 (UTC)

York review link is broken. Please format the references fully so one can figure out what they refer to. Doc James (talk · contribs · email) 20:39, 9 April 2016 (UTC)

Gremlins! Should work now: [3]--Aspro (talk) 21:35, 9 April 2016 (UTC)

This is not a review article [4]. This is a comment on a review article that is from 2000 and the comment was from 2003. Doc James (talk · contribs · email) 08:17, 10 April 2016 (UTC)

I sometimes wonder if you do this on purpose. Where did I say it was a review. It is a statement from the Centre for Reviews and Dissemination itself. Pointing out their concerns that their own study (Called the York review) is being cherry pick too much. Just pointing out to you that these misrepresentations are now bleeding into this article.--Aspro (talk) 18:41, 12 April 2016 (UTC)

Which misrepresentations are bleeding into this article? Doc James (talk · contribs · email) 18:49, 12 April 2016 (UTC)

Cochrane review says "Our review found that water fluoridation is effective at reducing levels of tooth decay among children. The introduction of water fluoridation resulted in children having 35% fewer decayed, missing and filled baby teeth and 26% fewer decayed, missing and filled permanent teeth. We also found that fluoridation led to a 15% increase in children with no decay in their baby teeth and a 14% increase in children with no decay in their permanent teeth. These results are based predominantly on old studies and may not be applicable today." and does not comment on "surprise".

Basically this is not supported "Major systematic reviews (York 2001, NRC 2006, Cochrane 2015) cited their surprise on the absence of high quality research for the benefit and potential harm of water fluoridation" Doc James (talk · contribs · email) 20:42, 9 April 2016 (UTC)

Newsweek and Scientific America are not good enough sources. Doc James (talk · contribs · email) 21:03, 9 April 2016 (UTC)

I agree with the removal of the new info for the reasons given. --Ronz (talk) 15:55, 10 April 2016 (UTC)

Thanks for the input. The chair of the NRC review stated his surprize in scientific american, and the chair of York stated it in Newsweek, plus the clarification statement york published in 2003. I was mistaken by using the word surprize for the Cochrane review, the co writer didn't mention it in Newsweek. Those pulicashions are adequate for citing a view of an expert on his own work. So just remove the word surprise from that paragraph. All three mention the lack of quality research and ambiguity in the conclusions. Here is the Cochrane summary read the last section http://ohg.cochrane.org/news/highlighted-review-water-fluoridation-prevention-dental-caries. One of the main reason health authorities endorse water fluoridation is the reason of closing health inequalities of the poor, while York 2001, EU SCHER 2010, and Cochrane 2015 state the data cannot make such a conclusion. Here's SCHER conclusion section: "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." http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/l-3/5.htm#0 Bigbaby23 (talk) 04:25, 11 April 2016 (UTC)

• Article already says "A 2015 Cochrane review found no conclusive research in adults.[59] It found evidence that water fluoridation was effective at reducing caries levels in children in studies from before 1975, and that these old studies might not be applicable today.[59]" and it mentions that the measure is opposed by some. (Cochrane is focused on looking for one particular kind of evidence, generally.) This seems in due weight with the best-quality sourcing. Individually-chosen op-ed's are a poor way to get to WP:DUE. Zad68 12:39, 11 April 2016 (UTC)

Second draft

The question of wp:due was raised. I have added a major source demonstrating that this paragraph is a mainstream view:

While health organizations such as the World Health Organization , the FDI World Dental Federation and many others have endorsed water fluoridation as safe and effective for many years, and the Centers for Disease Control and Prevention even listing water fluoridation as one of the ten great public health achievements of the 20th century in the U.S.; the practice is still controversial as a public health measure on ethical and scientific grounds, due to significant public opposition supported by a minority of experts, Major systematic reviews (York 2001, NRC 2006, Cochrane 2015) have cited the absence of high quality research for the benefit and potential harm of water fluoridation, and questions that are still unsettled. According to a 2013 Congressional Research Service report on fluoride in drinking water; this gap in knowledge is what's fueling the controversy.

References

• Please format the references similar to the rest of the article. Some of these reports need page numbers. Also we do not need this many citations to support that it is controversy.
• Just because a lot of organizations support it does not relate to it being controversial. This should be split into two sentences. We are we using newsweek and scientific america as sources? Doc James (talk · contribs · email) 16:54, 12 April 2016 (UTC)
• Many of these sources have been brought up before and found to be problematic, see for example Talk:Water_fluoridation/Archive_10#Edits_reverted_of_4.2F4.2F14 for discussion of SCHER and others. Not saying there isn't support for some kind of mention here, using some of the sources cited, but we need to make sure we don't use problematic sources, and in particular I think the second sentence proposed has a WP:SYNTH problem. The first sentence looks like it could get us somewhere, although we have to be careful to clarify what is meant by "controversy"--is it really a controversy among public health authorities (it doesn't seem that way) or it is more of a social and political "controversy" perpetuated by not-all-that-well-informed advocacy groups? Zad68 17:21, 12 April 2016 (UTC)

Agree with Zad68; if we are to discuss "controversy" we have to include context as to what the controversy is. I also agree with concerns above that the sources being used such as the Congressional Research Service and Scientific American are less than ideal and certainly should not be used to directly rebut higher quality sources. Yobol (talk) 21:23, 12 April 2016 (UTC)

Doc James:

• oy, gonna need help with that one. i do not know how to format references from journals etc. I just know the usual "cohen, mark (12 october, 2001) article name link, retrieved 10 november, 2015". + i removed 2 refs, so 3 solid citations for controversy
• the Congressional research service report makes that connection, page 1-2, 4. And so does the chair of the nrc in SA. The newsweek and SA are simply complementary to the reviews , as they add more info from the authers themselves specifically on this topic.

Zad68:

• I found easily references to SCHER as the EU commision review on fluoride. It is referenced by the ADA as the EU commision review , also listed by health New Zealand as a major review, the American cancer society lists them, zhealth Alberta Canada http://www.health.govt.nz/our-work/preventative-health-wellness/fluoridation/fluoridation-resources/fluoridation-research-and-review http://www.ada.org/~/media/ADA/Advocacy/Files/160115_nih_ntp_fluoride_nosig.ashx http://www.health.alberta.ca/documents/Water-Fluoridation-Position-Statement-2014.pdf. http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/water-fluoridation-and-cancer-risk it the position of the EU they are cited by many on google scholar.
• There is no Synth problem.
• Your ideas on the controversy are Original Research. Stick to the multiple citations wording about the controversy.Bigbaby23 (talk) 19:02, 12 April 2016 (UTC)

WP:MEDHOW explains it. Doc James (talk · contribs · email) 19:21, 12 April 2016 (UTC)

Thanks its done. Though reference number 3 refuses to behave...Bigbaby23 (talk) 21:13, 12 April 2016 (UTC)

There, have I got ref 3,4,5 right for you now?--Aspro (talk) 23:00, 12 April 2016 (UTC)

Thinks somebody is attempting to paint User:Bigbaby23 into a corner. Like no primary sources. Yet when good secondaries are added to this article, they get immediately deleted on the circular argument, that any secondary sources which don't reflect past orthodox US scientific beliefs (which may be well out of date now in 2016) the secondaries must therefore be fringe. --Aspro (talk) 20:15, 12 April 2016 (UTC)

Well they just removed a 2007 secondary source from the article. Doc James (talk · contribs · email) 18:19, 13 April 2016 (UTC)

I have added a sentence to clarify the "controversy" as mentioned above. The first sentence is a direct quote of the first citation page 331 ( albite with minor semantic change of words for copyright reasons), accessable freely here https://www.uow.edu.au/~bmartin/pubs/88sss.pdf. supported by two more citations of the same nature. Plus the nature of the dispute.Bigbaby23 (talk) 10:53, 14 April 2016 (UTC)

There was an article in the Guardian yesterday. Something in the water: is fluoride actually good for cities? It quotes both Peckham's paper Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention and the vitriol he suffered from having it published.

 Peckham, Stephen & Awofeso, Niyi  (2014) Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention  The Scientific World Journal. dx.doi.org/10.1155/2014/293019. Retrieved April 14, 2016 

I've included the Digital Object Identifier (dx.doi.org/10.1155/2014/293019) because that's what its there fore. I’m placing this paper here on the talk page because I am fed up with be accused of being both pro and anti on some of these articles when all I am trying to do is be neutral. --Aspro (talk) 12:23, 14 April 2016 (UTC)

Not casting aspersions on anyone here, but The Scientific World Journal is a real garbage journal. I checked the board of editors, which is a quick way to assess the scholarly muscle behind a journal. I was sent to a site http://www.hindawi.com/journals/tswj/editors/, which lists many subfields of science (kinda weird). So then I clicked on my specialty (inorganic chemistry), and got sent to this list. http://www.hindawi.com/journals/tswj/editors/inorganic.chemistry/

This is a list of 98% nobodies at low key institutions. Lots of folk from the Middle East, always a worrying sign. Then I checked "organic chemistry", which I dabble in, again nobodies. The antifluoride advocates often publish in very low quality journals. I am not saying that their concerns are without merit,its just that they havent published MEDRS level stuff in top notch places (NEJM, Lancet, Annals of ..). One approach for fortifying any discussion would be consult the top dental textbooks used in the top dental programs. --Smokefoot (talk) 02:35, 15 April 2016 (UTC)

To reflect the sources better the Second draft needs to be more clear that the controversy is not among the most authoritative public health bodies--according to them, flouridation is a net public health benefit with the expectation of signficant public health benefits and negligible risks, when done properly. There is a minority that questions it, and there is a (relatively) small amount of public-citizen advocacy against it, and sometimes that advocacy is poorly-informed. If that can be made more clear in the draft it would be easier to support. Zad68 04:01, 15 April 2016 (UTC)

One of the sentences has more than 60 words. This is not lead material. Belongs in the body if anywhere.

By the way all the evidence supporting the use of ASA in MIs is from the 1980s. Just because the underlying research is old does not mean it is useless.

My concerns of cobbling together unrelated stuff into a single sentence and the use of poor sources like newweek have not been addressed. Doc James (talk · contribs · email) 15:23, 15 April 2016 (UTC)

Zad68 comments that there is too little text, Doc James comments there is too much text ... :) Doc James, I replaced the newsweek and scientific american with 2 references the first a scholarly book, who quotes the chair of York and chair of NRC. (Pages 30-31), the second a review of the book published in a journal. The problem is not the age of the studies but their quality, york and Cochrane talk about the ambiguity of the mentioned effect. According to Cochrane the age has to do with the relevance of this ambiguous effect in relating to the pre fluoride toothpaste era and after it. Bigbaby23 (talk) 18:15, 15 April 2016 (UTC)

Regarding cobbling together: references 6 and 13 present the issue as endorsements vs opposition .Bigbaby23 (talk) 18:33, 15 April 2016 (UTC) These are not particularly good sources to support the content they are behind

• Connett, P. H. (2010). The case against fluoride : how hazardous waste ended up in our drinking water and the bad science and powerful politics that keep it there (pages 30-31). White River Junction, Vt: Chelsea Green Pub. ISBN 9781603582872.
• Peckham, Stephen (2012). "Book Reviews: The case against fluoride: how hazardous waste ended up in our drinking water and the bad science and powerful politics that keep it there, by Paul Connett, James Beck, and H Spedding Micklem". Critical Public Health. 22 (1): 113–114. doi:10.1080/09581596.2011.593350. ISSN 0958-1596.

Doc James (talk · contribs · email) 19:16, 15 April 2016 (UTC)

I didn't insist on more text but rather the text that is used needs to address the points I raised. The draft still doesn't make clear that the "controversy" is among a minority of public health practitioners and the public, rather than authoritative bodies. And this enormous paragraph does not belong in the lead. The brief mention of this as currently appears in the lead is sufficient, this discussion is over what should be mentioned in the body. Zad68 19:17, 15 April 2016 (UTC)

The Cochrane review states "Our review found that water fluoridation is effective at reducing levels of tooth decay among children." Doc James (talk · contribs · email) 19:20, 15 April 2016 (UTC)

Doc James Edit of the second draft: Health organizations such as the World Health Organization and FDI World Dental Federation have supported water fluoridation as safe and effective for years. The Centers for Disease Control and Prevention lists water fluoridation as one of the ten great public health achievements of the 20th century in the U.S. The practice is controversial as a public health measure based on ethical and scientific grounds. Reviews cite the small amount of high quality research regarding the benefit and potential harm of water fluoridation. According to a 2013 Congressional Research Service report on fluoride in drinking water; this gap in knowledge is fuels the controversy.

References

Doc James, The Cochrane review also states(as I have wrote above): "Quality of the evidence -

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. For example, many did not take full account of all the factors that could affect children’s risk of tooth decay or dental fluorosis. There was also substantial variation between the results of the studies, many of which took place before the introduction of fluoride toothpaste. This makes it difficult to be confident of the size of the effects of water fluoridation on tooth decay or the numbers of people likely to have dental fluorosis at different levels of fluoride in the water" Bigbaby23 (talk) 20:00, 15 April 2016 (UTC)

The discussion is not about what should be in the body. This is notable enough to be in the lead. Guys I have accomodated your comments with good faith. But now it is starting to feel like a pov strategy to kill this addition.Bigbaby23 (talk) 20:00, 15 April 2016 (UTC)

Third draft

Doc James version (see above) with a change - the reviews cite lack of, not small amount existing.

Health organizations such as the World Health Organization and FDI World Dental Federation have supported water fluoridation as safe and effective for years. The Centers for Disease Control and Prevention lists water fluoridation as one of the ten great public health achievements of the 20th century in the U.S. The practice is controversial as a public health measure and has led some countries to discontinue it and others to expand it. Reviews cite the lack of high quality research regarding the benefit and potential harm of water fluoridation. According to a 2013 Congressional Research Service report on fluoride in drinking water; this gap in knowledge is what fuels the controversy.

References

BigBaby, the content needs to explain who find the practice contoversial in the sentence "The practice is controversial as a public health measure based on ethical and scientific grounds." I requested this above also, still don't see it in the draft. Again, the major authoritative bodies aren't the ones agonizing over it. Regarding the sourcing, two of the sources supporting the problematic sentence don't indulge the idea that water fluoridation is worrisome, so the draft still appears to misuse those sources. The SCHER source used to support "controversy" only mentions "controversy" briefly in a section that explains why the paper was produced. Studying the controversy wasn't the purpose of the paper. The SCHER paper itself states as its conclusions "Small doses of fluoride when teeth are developing can help prevent tooth decay." (this is the first sentence of the 3-level presentation) and it doesn't indicate that risks should be expected at the recommended levels. The Richards paper is really studying the use of open-access format systematic review, and the fluoridation discussion is just a case study used as an example. This leaves the brief Cheng 2007 PMC review Adding fluoride to water supplies which does appear useful for the purpose you're driving at, looking at that now. And again this is for the body, the brief mention already in the lead appears to provide due weight. Zad68 22:47, 15 April 2016 (UTC)

Zad Incorrect about SCHER. you meant level 1 summary not 3. That sentence is in regards to all forms of fluoride use:

"Small doses of fluoride when teeth are developing can help prevent tooth decay. They can come from drinking water – either naturally or artificially fluoridated, from toothpaste, mouthwash or dental gel. Artificial fluoridation of drinking water reaches the whole population, but is a controversial as a public health measure. Too much fluoride may be harmful, leading to discolouration and even damage to teeth from fluorosis. It has also been suggested that excess fluoride may have other health effects."

And on level 3 fluoride and tooth decay prevention conclusion: they see no benefit of water fluoridation over topical use. And conclude and reccomend that topical is most effective. http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/l-3/5.htm#0

on level 3 introduction there is also more about the controversy: http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/l-3/1.htm#0

"There is a continuous controversy over the benefit of fluoride and, in particular, the practices of intentional water fluoridation in tooth decay prevention. This has led to several countries discontinuing drinking water fluoridation and others expanding it."Bigbaby23 (talk) 04:43, 16 April 2016 (UTC)

I have inserted SCHER description of the controversy in the paragraph.Bigbaby23 (talk) 05:01, 16 April 2016 (UTC)

Doc James: As for the justification of the sentence: "Reviews cite the lack of of high quality research regarding the benefit and potential harm of water fluoridation" York describes the resesrch as Moderate to low. Cochrane characterize them: "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. 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. ".Bigbaby23 (talk) 11:04, 16 April 2016 (UTC)

That Cochrane come to a positive conclusions is an indication that there is at least some okay research in children.

What parts of the two reviews support "Reviews cite the lack of of high quality research"? The Cochrane review does not use that wording. Doc James (talk · contribs · email) 13:59, 16 April 2016 (UTC)

This Cochrane review includes the caveat:

There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010856.pub2/abstract?systemMessage=Subscribe+and+renew+is+currently+unavailable+online.+Please+contact+customer+care+to+place+an+order%3A++http%3A%2F%2Folabout.wiley.com%2FWileyCDA%2FSection%2Fid-397203.html++.Apologies+for+the+inconvenience.

In other words cofactors were not considered to be in their scope. So the 'positives' are still hypothetical. I think this addition by Bigbaby23 is ready to be placed on the article page (unless some want it to die by the death of a thousand cuts edits).--Aspro (talk) 15:51, 16 April 2016 (UTC)

Doc James it is stated in both Reviews:

York "The quality of studies was low to moderate. It's in the abstract/results " http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27492/

Cochrane defines the quality of the studies in a graph with small symbols , and links to an explanations of the symbol grade. all the studies about children and carier prevention are graded 2 stars = Low quality

see the graph at "Summary of findings" in the full review http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010856.pub2/full Next to the heading is a link "explanation" which leads to http://www.cochranelibrary.com/about/explanations-for-cochrane-summary-of-findings-sof-tables.htmlBigbaby23 (talk) 17:21, 16 April 2016 (UTC)

Aspro, now that the "quality" issue has been resolved. I see no reason why not to post it, and move on with our (my) lives .Bigbaby23 (talk) 17:43, 16 April 2016 (UTC)

Bigbaby I said "3-level presentation" and that's what I meant. It's a 3-tier presentation of the findings, at increasing levels of detail. The finding I was mentioning was at tier 1 of the 3-level presentation. Like most every other source, the SCHER document warns against too much fluoride, and regarding your comment "they see no benefit of water fluoridation over topical use"--this isn't the point. Sources indicate fluoridation is of benefit to those who do not do or do not have access to topical. Please take more care to read what people write. The proposed text still doesn't address the concerns I had brought up from the start, this still isn't ready to add to this FA-rated article. Zad68 02:17, 17 April 2016 (UTC)

Zad you wrote with a direct quote: "Small doses of fluoride when teeth are developing can help prevent tooth decay." (this is the first sentence of the 3-level presentation). As i have stated that is not taken from the 3 level presentstion intro or what ever. But from the 1-level presentation. And you have braught only part of the paragraph which distorted its meaning.

SCHER conclusion of "what role does fluoride play in preventing tooth decay" (level-3):

"Conclusion

Water fluoridation as well as topical fluoride applications (e.g. fluoridated toothpaste or varnish) appears to prevent caries, primarily on permanent dentition. No obvious advantage appears in favour 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. 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."

you write "Sources indicate fluoridation is of benefit to those who do not do or do not have access to topical"

SCHER: 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."

York: "The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable"

Cochrane: "We found insufficient information to determine whether fluoridation reduces differences in tooth decay levels between children from poorer and more affluent backgrounds"

You were also proved not correct about your first accusation about SCHER notability. Your link to a past discussion about it in the talk page, show your POV to be too bias bordering on gatekeeping. You have proven to be dishonest in this debate and unreliable.The current draft was cut and arranged by admin Doc James, the only argument has been about the studies quality citation, and that has been setteled.Bigbaby23 (talk) 06:10, 17 April 2016 (UTC)

A number of your changes have introduced errors. The references are not formatted correctly. So no I do not exactly support your changes. Doc James (talk · contribs · email) 16:25, 18 April 2016 (UTC)

I was referring your name above, only to the paragraph discussed. This long debate as a whole "forced" me to examine closely all the sources, which later led me to realise that the lead was not presenting them or conflicting with them, in many places. I have no quarrels to your edits of my post third draft additions.Bigbaby23 (talk) 03:56, 19 April 2016 (UTC)

Bigbaby23, sorry but seriously you're still not actually reading and addressing what I wrote so that makes it difficult to have this conversation with you. Look at the bottom of the SCHER source, it describes itself as a GreenFacts Three-Level Structure. It is a document style/structure. There are three levels. The conclusion I mentioned was from the first level (plain language without detail for the layman) of the three-level structured presentation. Regarding water, the second sentence from Level 1 of SCHER is "Small doses of fluoride when teeth are developing can help prevent tooth decay. They can come from drinking water – either naturally or artificially fluoridated, from toothpaste, mouthwash or dental gel." So your point doesn't stand when compared to the source. However I feel like we're veering away from working on article content to arguing about the topic, which is not what the article Talk page is for. Zad68 12:37, 18 April 2016 (UTC)

What is going on with all the rapid changes? QuackGuru (talk) 17:24, 18 April 2016 (UTC)

Maintaining FA-quality

With the recent series of edits, we have more work to do to try to keep this article at FA-standard. Specifically, the formatting of the refs needs to be groomed so that they stay consistent. Also: there should never been a source used in the lead that isn't used in the body. The lead must summarize the body--this means that there cannot be content or sourcing in the lead that isn't covered more expansively in the body. Zad68 13:13, 18 April 2016 (UTC)

DoneBigbaby23 (talk) 04:14, 19 April 2016 (UTC)

WHO stance

WHO stance seems to be evolving. Their 2011 guide to clean water emphasizes the many parts of the world where local fluoride levels are too high and talks about removing it, along with arsenic and nitrates, due to bone damage from long term exposure to excessive levels. They are still very clear that adding fluoride where levels are below about .5mg/l is good for public health, but the emphasis seems to have really changed since the 1990s. Jytdog (talk) 06:22, 20 April 2016 (UTC)

Arvid Carlsson mention in Ethics section

The Carlsson addition discussed is in the opening paragraph of the Ethics and Politics section:

Fluoridation can be viewed as a violation of ethical or legal rules that prohibit medical treatment without medical supervision or informed consent, and that prohibit administration of unlicensed medical substances. Arvid Carlsson also adds the view that the addition of fluoride to water supplies violates modern pharmacological principles meaning; the individual variation in response, which can be considerable even when the dosage is fixed.

It can also be viewed as a public health intervention, replicating the benefits of naturally fluoridated water, which can free people from the misery and expense of tooth decay and toothache, with the greatest benefit accruing to those least able to help themselves. This perspective suggests it would be unethical to withhold such treatment.

References

The addition of the Arvid Carlsson sentence was added because it adds another perspective (pharmacological) to the list of reasons, by a very notable and expert pharmacological figure . It was reverted on the claim by zad68 "please get consensus on Talk, The Fluoride Deception isn't appropriate and Carlsson isn't in dental or public health"

I find the reasoning for the revert poor, the second reason to be of NGF. Firstly the book is not just quoting Carrlson (like many other alternative books missleading endorsments). Carlsson himself wrote the poscript for the book. Secondly, the book is notable enough to be reviewed in Chemical & Engineering News; the magazine published by the American Chemical Society, and reviewed by a notable expert Sheldon Krimsky. I maintain that the book is perfectly relaible source for the non MEDRS section Ethics and politics. If it is directly used just to quote Carlsson.

Thirdly, The review specifically mentions Arvid relevancy and prominency to the fluoride debate stating "Few people of prominence will stand up and contest the issue of the safety of fluoride compounds, Bryson claims. One exception is Arvid Carlsson, a Swedish pharmacologist who shared the 2000 Nobel Prize in Physiology or Medicine. In a postscript to the book, Carlsson writes: "Fluoride is a pharmacologically very active compound with an action on a variety of enzymes and tissues in the body already in low concentrations. In concentrations not far above those recommended it has overt toxic actions." Carlsson was one of the scientists who helped persuade the Swedish Parliament to ban fluoridation of drinking water in that country."

The statment i quoted/paraphrased for the wkipedia article was taken from the poscript in the book Page 204] (viewable in Google books).

P.S : Personaly i don't get why such a harmless addition needs such a discussion in the first place, especially after my second edit of it, which accomodated the notice and trimmed it. After my previous encounter with zad68 on the lead edits talk page discussions above, it seems WP:TENDENTIOUS motivated. And frankly- annoying.Bigbaby23 (talk) 05:19, 19 April 2016 (UTC)

I thought that the inclusion of the Arvid Carlsson quote to be inappropriate. He is no dental expert. One could also quote Ralph Nader, another prominent critic. The problem with this tactic is that individual critics will be outspoken, by definition, and supporters of the status quo would be silent. The Arvid Carlsson thing would be fine in the controversy article. My two cents. Also why doesnt he critcize iodized salt, another example of mass medication. --Smokefoot (talk) 13:28, 19 April 2016 (UTC)

Can -Smokefoot run that past me again? The fact that many motorist can walk away with just bruises from a bad auto- crash today is because of out-spoken critics like Ralph Nader who forced car manufactures to design in safety features. I can remember those days when a front collision forced the non collapsible steering wheel to impact the drivers chest (fatal) and for a rear end shunt to rupture the fuel tank and incinerate the occupants (fatal). Door flying open, rear view mirrors that sliced a face apart when the occupant hit them, those fancy hood ornaments that sliced open pedestrians, etc. Road deaths have come down a lot since then and yet automobile usage has gone up. What about the less high profile critics that championed the fitting of smoke detectors in homes, earth leakage trips etc. These weren’t industry sponsored improvements but brought about by people (critics as you call them) that care for human life. You should be grateful that critics risk appearing unpopular, because their altruistic efforts make our (and your) world safer. Iodized salt? It creates a choice and is an essential element. So if you have a real point to make then make it.--Aspro (talk) 15:51, 19 April 2016 (UTC)

Ooookay. The topic here is the appropriateness of invoking/quoting famous people - just because they are famous - when discussing water fluoridation. My second point, dueling with the Nobelist, is that table salt is iodized whether the consumer needs that iodide or not. But we should probably stick to the specific style of argument. --Smokefoot (talk) 17:22, 19 April 2016 (UTC)

Not arguing that it's a WP:V problem, I have no doubt Carlsson said it. But the source you're citing The Fluoride Deception isn't published by an academic publisher, it's published by Seven Stories Press which is a platform for activists by advocates. I can't find any background for the author Christopher Bryson that would make us think he's a well-educated, sober, even-handed voice of reason regarding dental public health. And as was already pointed out Carlsson isn't in dental or public health. It's entirely the wrong kind of source to use for that purpose in a WP:FA. Zad68 17:38, 19 April 2016 (UTC)

@ Zad68
It was Smokefoot that introduced the tangential to Ralph Nader which needed to be answered, yet his edit still stands! Can see now why JW is getting concerned that WP is drifting away from his vision. Looking over several years history of edits here, their is now very much prima facie evidence that some editors are trying to own this article. So I have reverted your hat so that you can argue your case on the appropriate WP forum. Enough said?--Aspro (talk) 18:00, 19 April 2016 (UTC)

In the appropriate forum at the appropriate time we can go over your edits here, but let's use this Talk page to discuss improvements to the article. Zad68 18:03, 19 April 2016 (UTC)

Said above (unless some want it to die by the death of a thousand cuts edits). I was handing out the rope to see how much of that rope some editors would wind around their necks. “In the appropriate forum at the appropriate time we can go over your edits here” that is a good example of mixing premises. The statement doesn't make sense. Some editors are trying to improve this article but some... shall we say... are using Wikilawyering and secondary clarifications in an attempt that they are implying a wholly NPOV in order to maintain ownership. This behavior is not something to be discussed here on the talk page.--Aspro (talk) 20:00, 19 April 2016 (UTC)

I see some folks adding UNDUE weight to minority perspectives. That is not "improvement" per NPOV. Jytdog (talk) 21:22, 19 April 2016 (UTC)

What kind of arguments are these, Smokefoot and Zad? Smokefoot - A. He's a notable Pharmacologist commenting on the pharmacological aspect of WF, why do you find a dentist more relaible to comment on this? Absurd! B. He's relevancy to the WF debate is his documented role in the Sweden WF ban. C. The supporters are not silent; under this paragraph in the article, is a long list of endosments to WF.

Zad - A. You say you cannot asses if this book and the author are "well-educated, sober, even-handed voice of reason", yet my second reference (chemical & engineering news book review by sheldonk.) has done just that. And in any case my addition doesn't include one word from the author or his research snd concludions.

Jytdog - We need to be careful not to abuse WP:UNDUE. only in the case of "tiny minorities" total removal is the first option to consider. Water fluoridation opposition view is significant enough to be extensivley reviewed in the article including the lead according to the references. Since you are worried about the misconception; It is possible to just add (taken from the book review in chemical & engineering news- see above) a pre clarification to the suggested sentence "Few people of prominence will stand up and contest the issue of the safety of fluoride compounds,"... Arvid Carlsson .......". His notability in the Pharmacological community (nobel winner) and notability in the WF due to his participation and role in Swedens WF ban; warrants our addition of his opinion, especially when it is an addition to the reason opponents oppose the practice.Bigbaby23 (talk) 02:07, 20 April 2016 (UTC)

Sure but the size of this section is completely out of whack. We have Water fluoridation controversy article cited as main. The section here just be a WP:SUMMARY of that, and Arvid Carlsson isn't even mentioned there, where all the detail should be. Makes no sense that we are even having this discussion here. Jytdog (talk) 02:15, 20 April 2016 (UTC)

Oh! how Kafkaesque this is becoming! Looking at that article and its history log: Carlsson and all other who oppose including organizations are not mentioned there because of Wp:undue! look - https://en.wikipedia.org/w/index.php?title=Water_fluoridation_controversy&diff=627841122&oldid=627786820 .Off course that is rediculous, and it seems that article has been steered by a cabal of pro fluoridation supporters to becoming competly neutered. What's left there is mostly a copy of the water fluoridation article. That article needs to be merged into this one. But that is a different topic. Going back on topic: So you agree that one small line about Carlsson with a small notice about minority opinion is ok regarding WP:Undue. Good. Bigbaby23 (talk) 03:43, 20 April 2016 (UTC)

Seconded, go to the controversy article. Carl Fredik 💌 📧 10:46, 20 April 2016 (UTC)

BigBaby cites as evidence for "Water fluoridation opposition view is significant" the chemical & engineering news article cited above. The article is about a "citizens' conference" organized by Paul Connett and the Fluoride Alert Network that he leads. Fluoride Alert Network is literally a mom ("Managing Director")-and-pop ("Executive Director") organization, now with their son in a leadership role (how's that for objectivity!). Pop (Paul Connett) is a long retired prof from a small liberal arts college. Its lack of credibility is demonstrated by the fact that PubMed (branch of U.S. Public Health Service) not does not recognize his organization's journal. Conclusion: this mention in Chem and Eng News is not evidence that "Water fluoridation opposition view is significant", quite the contrary. Presenting this kind of news report as evidence for significance is tantamount to deception. --Smokefoot (talk) 13:41, 20 April 2016 (UTC)

Bigbaby23 re your response " You say you cannot asses if this book and the author are 'well-educated, sober, even-handed voice of reason', yet my second reference (chemical & engineering news book review by sheldonk.) has done just that" -- Unfortunately once again your response doesn't meet my point, and the book review (which should be irrelevant anyway regarding this article) does not in any way provide the information I requested. Did you even read the review? Zad68 13:46, 20 April 2016 (UTC)

The sub articles of the main article relevance

Controversy

• OK, the "controversies" section in this aticle had become completely uncoupled from the actual Water fluoridation controversy article. I copied all of the content in it over there, blended it (and also added the content about Arvid Carlsson discussed in the OP of this section) and then worked on the lead of that article so that it summarized that article, per WP:LEAD. Per WP:SYNC I then copied the lead of that article and pasted it here. This is how you keep split articles synchronized. This kind of meta-editing is super important so that Wikipedia is saying one thing, and not contradicting itself. WP needs pruning this way for inter-related suites of articles like this. Jytdog (talk) 05:41, 20 April 2016 (UTC)

On a second look, i merged all the controversy relevant material into the main article. Its not so much. Most of the sub article has nothing to do with controversy, and is just copy paste from the main article. The sub article can be deleted now.Bigbaby23 (talk) 09:05, 20 April 2016 (UTC)

Subarticles are a good idea for this content. Have restored it. Doc James (talk · contribs · email) 15:46, 20 April 2016 (UTC)

Alright.Bigbaby23 (talk) 16:25, 20 April 2016 (UTC)

Agree per WP:SUMMARY style, but Jytdog is correct that they're overdue for a sync-up. Zad68 15:48, 20 April 2016 (UTC)

Structure of the article looks great now! Jytdog (talk) 16:52, 20 April 2016 (UTC)

History

Note, the History of water fluoridation article was almost exactly the same as the same section in this article, with some weird differences. I merged that article into this one. No signifcant change in length here. Once less thing to keep SYNCed. Jytdog (talk) 06:08, 20 April 2016 (UTC)

Sounds good. Not excessively long. If it gets longer should be split out with just a summary here though. Doc James (talk · contribs · email) 15:48, 20 April 2016 (UTC)

Addition

This ref "A 2007 Nuffield Council on Bioethics report concluded that good evidence for or against water fluoridation is lacking." is not a review

This ref "Systematic reviews have cited the lack of high quality research for the benefits and risks of water fluoridation and questions that are still unsettled." is also not to the review but to a press release about the review and needs to be formatted properly.

We have a Cochrane review from 2015. We really do not need to be using this old reviews.

References

- Doc James (talk · contribs · email) 16:07, 23 April 2016 (UTC)

Belief?

Aspro, what is the basis, in the body of the article, for changing the language in the lead to "belief"? Jytdog (talk) 14:01, 25 April 2016 (UTC)

Belief: means accepting something without proof. So far, all that exists are unsubstantiated theories.--Aspro (talk) 14:04, 25 April 2016 (UTC)

The sources cited don't support watered-down wording like 'belief', it was correct to remove it. Zad68 14:06, 25 April 2016 (UTC)

Right, so unsourced editorializing on an FA. Jytdog (talk) 14:09, 25 April 2016 (UTC)

Added tag {{Globalize}}

Whether or not fluoridation is beneficial, the article lead does not reflect the world view. Indeed. if it reflects anything it is Wikipedia:Systemic bias.--Aspro (talk) 14:04, 25 April 2016 (UTC)

I removed it, worldwide perspective is covered. Zad68 14:08, 25 April 2016 (UTC)

The lead does not reflect the world view--Aspro (talk) 14:20, 25 April 2016 (UTC)

The WHO is a global public health body and their view is that water fluoridation is done for the purpose of public dental health. Zad68 14:24, 25 April 2016 (UTC)

The WHO stance (re: York Review discoveries et.al.) is based on old and much “poor quality” data. Aetiology and prophylactic measures now require higher standards in order to show risk/benefit. True, WHO have not yet revised their original position. However, many other counties have - and unilaterally and independently of WHO. Nullifying the argumentum ad verecundiam presented here. New insights on this subject need inclusion too. Therefore, this article's lead no longer reflects the world view. Medical science has moved on and Wikipedia should reflect the modern World view 2016. It would make it more accurate and up-to-date. --Aspro (talk) 15:41, 25 April 2016 (UTC)

You can't just add tags randomly, please elaborate why it does not reflect a global view. Carl Fredik 💌 📧 14:26, 25 April 2016 (UTC)

Just done so above. --Aspro (talk) 15:41, 25 April 2016 (UTC)

You clearly haven't read the most recent WHO source cited in this article. Jytdog (talk) 15:45, 25 April 2016 (UTC)

We cover WHO's position and therefore globalization tag not needed. Doc James (talk · contribs · email) 20:51, 27 April 2016 (UTC)

Edits today

About this; there is a whole slew of stuff there. More than anything, please stop prestige-shopping various sources. The whole thing about "the most respected review" is just POV-pushing. Please stop. As for the other changes, the Evidence section is arranged already with the most recent and authoritative reviews at the top, and goes back in time. Adding stuff about the 2015 review back in the history makes no sense. I can't figure out what you are doing BigBaby. Please tell us. Thanks. Jytdog (talk) 02:02, 25 April 2016 (UTC)

Jytdog, You are mistaken about this, and me. Please stop edit waring.

On page 31 of the full Cochrane review, they state : "The most widely recognised systematic review of water fluoridation was published in 2000 (McDonagh 2000). Our review aimed to update this review"

https://www.researchgate.net/profile/Zipporah_Iheozor-Ejiofor2/publication/261308953_Water_fluoridation_for_the_prevention_of_dental_caries/links/559cf6c808ae70ed9689e52c.pdf?inViewer=0&pdfJsDownload=0&origin=publication_detail

Naturally i changed it a little for copy edit reasons.Bigbaby23 (talk) 03:02, 25 April 2016 (UTC)

Not acceptable. You have not replied to the substance above at all. This thing you are doing of emphasizing the prestige of the sources that please you is not OK; we don't hype the prestige of sources. And you made a bunch of other changes, as I mentioned above. Jytdog (talk) 03:06, 25 April 2016 (UTC)

Doc James wrote above "We have a Cochrane review from 2015. We really do not need to be using this old reviews" and outlined the frame at which to work here, with in that section. Therefore I removed the Australian reference from summary, and removed the undue weight 2002 review, just like absence of notable reviews such as SCHER and the Australian reviews in section body.

Cochrane states its an update on York. Both are mentioned in the section because York Conclusion is efficacy in general (15%), and Cochrane conclusion is about "no other fluoride" etc.

The Cochrane statement about York is totally representative of the mainstream view. The EU 2011 SCHER review relies on York conclusions for efficacy in carier prevention. http://ec.europa.eu/health/scientific_committees/opinions_layman/fluoridation/en/l-3/5.htm#0. The 2007 Australian review, same thing http://www.nature.com/ebd/journal/v9/n2/full/6400575a.html .Bigbaby23 (talk) 03:44, 25 April 2016 (UTC)

Perhaps you didn't like the choice of my wording. Without thinking much I chose the word "respected" to replace "recognized" for copy edit reasons. We could use a different word thats equivalent to "recognized". Suggestions?Bigbaby23 (talk) 03:50, 25 April 2016 (UTC)

What you say there is kind of reasonable; it doesn't fully answer the problems but before we go further, please see your talk page. Jytdog (talk) 03:51, 25 April 2016 (UTC)

• My issue with "The most widely recognised systematic review of water fluoridation was published in the year 2000 (York review)." is that it does not relate to the section on evidence it was placed in.
• Kept this bit "The 2015 Cochrane review estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12%. This increases to 40% when considering fluorosis of any level not of aesthetic concern."
• Doc James (talk · contribs · email) 06:35, 25 April 2016 (UTC)

References

Doc James, why do you keep that 2002 review in the efficacy paragraph? It gives a misleading notion that it is comprehensive and authoritative equally to York and Cochrane. And why keep the Australian review reference in the evidence section lead, if we to follow the new ones?

should the "most widely recognised" paragraph be the opening paragraph of the efficacy section, then?Bigbaby23 (talk) 07:34, 25 April 2016 (UTC)

York is the oldest from 2000. And Cochrane states they are an update. But as it is not a well researched area I guess using older reviews is okay. Doc James (talk · contribs · email) 20:52, 27 April 2016 (UTC)

Effectiveness

The section Water fluoridation #Effectivenessis a poor resource for any lay reader wanting to know the answer to the question "How effective is fluoridation in reducing tooth decay?" The section spends all of it time recounting the history of studies and seems obsessed with York and a bunch of statistics. Who cares which review updated which other one? It's of no relevance to the reader, and researchers had better be reading the sources themselves. In addition, everything is attributed as if there was some dispute about about the conclusions of the reviews, which are actually pretty unanimous in their conclusions. Whatever happened to assert simple facts: "When a statement is a fact (e.g. information that is accepted as true and about which there is no serious dispute), it should be asserted using Wikipedia's own voice without in-text attribution."? ("Serious dispute" means among mainstream reliable sources, not among Wikipedia editors, of course).

There's a statement "A conclusion for the efficacy in adults is less clear with some reviews finding benefit and others not." sourced to PMID 26092033 (the 2015 Cochrane review) and PMID 19772843 (Parnell 2009). While Parnell found "water fluoridation is effective at reducing caries in children and adults", the Cochrane review found "No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria." In other words, the Cochrane review could say nothing about the effects of fluoridation on adults. It is disingenuous to treat that as a "review not finding benefit", because it simply was unable to examine the issue with the selection criteria it used. I could find another ten thousand reviews that didn't find benefit of fluoridation in adults because they never examined the issue. In summary, I don't agree that sources cited support the text "some reviews finding benefit and others not".

Finally, the summary in the lead consists of five sentences, two of these specifically refer to the Cochrane review: one to restate the statistics about children and the other to state the evidence quality was poor. That's not a neutral summary of the conclusions reached by the sources included in the Effectiveness section. Details about what a single review thought about the evidence it examined is a long way from being worthy of consideration in the lead. --RexxS (talk) 15:40, 28 April 2016 (UTC)

Completely agree. This going into the weeds about how different reviews relate to each other is very odd. We should just summarize the best sources' conclusions. Alexbrn (talk) 15:44, 28 April 2016 (UTC)

agree as well--Ozzie10aaaa (talk) 17:38, 28 April 2016 (UTC)

Regarding efficacy in adults, i don't see what the current problem is. The paragraph in efficacy section is clear:

"Fluoride may also prevent cavities in adults of all ages. A 2007 meta-analysis by CDC researchers found that water fluoridation prevented an estimated 27% of cavities in adults, about the same fraction as prevented by exposure to any delivery method of fluoride (29% average).[54] A 2011 European Commission review found that the benefits of water fluoridation for adult in terms of reductions in decay are limited.[15] 2015 Cochrane review found no conclusive research in adults.[53]" Bigbaby23 (talk) 03:02, 29 April 2016 (UTC)

I disagree regarding your argument about the efficacy paragraph about children. The reader gets the numbers clear. Also that the research quality is problematic , we quoted the 2 later major reviews (Australian, EU) both repeating york. Cochrane states it is an update to York. (page 31). And repeats the quality problems in the Literature.Bigbaby23 (talk) 03:12, 29 April 2016 (UTC)

The lead is fine by quoting the newest review and from the most reputable source, and it is not in conflict with that section. Bigbaby23 (talk) 03:20, 29 April 2016 (UTC)

Agree with Alex and Ozzie, the presentation of effectiveness has really deteriorated to the point that now it's a rather unreadable mess. The section needs to return to following WP:MEDMOS where we identify the best-quality, authoritative reliable secondary sources and we summarize them, without adding unnecessary mentions of individual years, studies, publishers and authors for the reader to stumble over. Zad68 12:46, 29 April 2016 (UTC)

April 28, 2016

Hi folks! Here's a little background. Thoughts? Anna Frodesiak (talk) 6:07 am, Yesterday (UTC−4)

had commented here[5] as original link had been archived --Ozzie10aaaa (talk) 14:11, 29 April 2016 (UTC)

Controversy section

I've been trying to synch the controversy section with the controversy sub article lede.

Alexbrn reverted twice with the comments "Best to[not] to sync to an inferior mess" and then "yeah and the sub-article is a mess; don't contaminate this FA with it."

This is the current sections text:

The water fluoridation controversy arises from political, moral, ethical, economic, and safety concerns regarding the fluoridation of public water supplies. Those opposed argue that water fluoridation may cause serious health problems, is not effective enough to justify the costs, and has a dosage that cannot be precisely controlled.[106][107][108][109]

With regard to ethics, like vaccination and food fortification, fluoridation pits the common good against individual rights.[32][110]

Opposition to fluoridation has existed since its initiation in the 1940s.[111] During the 1950s and 1960s, conspiracy theorists claimed that fluoridation was a communist plot to undermine American public health.[112] In recent years water fluoridation has become a pervasive health and political issue in many countries, resulting in changes to public policy regarding water fluoridation.[10][113]

Public health authorities find a medical consensus that water fluoridation at appropriate levels is a safe and effective means to prevent suffering and promote oral health, and generally support fluoridation.[114] Opponents of fluoridation include some researchers, dental and medical professionals, alternative medical practitioners, health food enthusiasts, a few religious groups (mostly Christian Scientists in the U.S.), and occasionally consumer groups and environmentalists.[115] Organized political opposition has come from libertarians,[116] the John Birch Society,[117] and from groups like the Green parties in the UK and New Zealand.[118]

Refs can be seen in the section https://en.wikipedia.org/wiki/Water_fluoridation#Controversy

This is the sub article relevent lede text, that was trying to synch:

The water fluoridation controversy arises from political, moral, ethical,economic, and safety concerns regarding the fluoridation of public water supplies. Those opposed argue that water fluoridation has no or little cariostatic benefits, may cause serious health problems, is not effective enough to justify the costs, and pharmacologically obsolete.[1][2][3][4]

With regard to Medical ethics, a 2007 Nuffield Council on Bioethics report concluded that good evidence for or against water fluoridation is lacking, therefore local and regional democratic procedures are the most appropriate way to decide whether to fluoridate.[5] Water fluoridation pits the common good against individual rights. Some say the common good overrides individual rights, and equate it to vaccination and food fortification.[6][7] Others say that individual rights override the common good, and say that individuals have no choice in the water that they drink, unless they drink more expensive bottled water,[8] and some argue unequivocally, that it does not stand up to scrutiny relative to medical ethics.[9]

Opposition to fluoridation has existed since its initiation in the 1940s.[10] During the 1950s and 1960s, conspiracy theorists claimed that fluoridation was a communist plot to undermine American public health.[11] In recent years water fluoridation has become a prevalent health and political issue in many countries, resulting in some countries and communities discontinuing it's use while others have expanded it.[12][13] The controversy is propelled by a significant public opposition supported by a minority of professionals,[14] which include researchers, dental and medical professionals, alternative medical practitioners, health food enthusiasts, a few religious groups (mostly Christian Scientists in the U.S.), and occasionally consumer groups and environmentalists.[15] Organized political opposition has come from libertarians,[16] the John Birch Society,[17] and from groups like the Green parties in the UK and New Zealand.[18]

Public health authorities throughout the world find a medical consensus that water fluoridation at appropriate levels is a safe and effective means to prevent Dental caries.[19] The authorities views on the most effective Fluoride therapy for community prevention of tooth decay are mixed; some state water fluoridation is most effective while others see no special advantage and prefer topical application strategies.[20][21]

Proponents and opponents have been both criticized for overstating the benefits or overstating the risks, and understating the other, respectively.[22][23] Systematic reviews have cited the lack of high quality research for the benefits and risks of water fluoridation and questions that are still unsettled.[23][24][12] Researchers who oppose the practice state this as well.[25] According to a 2013 Congressional Research Service report on fluoride in drinking water, these gaps in the fluoridation scientific literature fuel the controversy.[26]

Ref can be seen in article lede https://en.wikipedia.org/wiki/Water_fluoridation_controversy

How is the sub article lede text "inferior" or more "contaminating"than the current text? Bigbaby23 (talk) 08:34, 29 April 2016 (UTC)

Well since the sub-article lede is over-long and carries novel material in it (i.e. not summarizing article content) it is out-of-line with our WP:PAGs (despite the fact you've removed the maintenance templates alerting editors to this fact). So it's a mess. We don't compound that mess by repeating it here. Alexbrn (talk) 09:02, 29 April 2016 (UTC)

The novel material issue was just a duplicate ref problem. Fixed nowBigbaby23 (talk) 14:49, 29 April 2016 (UTC)