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March 3, 2016

Sensationalizing medical and dental studies

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There’s a lot of what I call medical and dental sensationalism that goes on in the online world. Shocking conclusions get traffic, and often they play to people’s biases.

Some of this sensationalizing is relatively innocent, as people slightly embellish the conclusions of legitimate studies. I reported on this blog last week on a story based on a research article about the oral pH of people who sleep with their mouth open. The article hypothesized that mouth breathing might lead to enamel erosion or decay. Widespread reporting on the study glossed over that this was merely a hypothesis.

Today I came across an article that is more of a designed attempt to promote an agenda. It comes from an online magazine, Uncommon Wisdom Daily, and the article is titled “Fluoride Classified as a Neurotoxin” by a writer named Brad Hoppman. It begins with the attention-grabbing statement: “The world’s oldest and most-prestigious medical journal, The Lancet, has officially classified fluoride as a neurotoxin. This puts fluoride in the same category as arsenic, lead and mercury.”

Errors in the Article

I looked up the study referenced, and uncovered a host of errors in their reporting of it. Let me list them.

1. The Lancet is the world’s most prestigious medical journal.
This is the beginning of the embellishment of the story. Yes, it’s a minor embellishment, but it gives us an idea of the mindset of the author. There is fairly widespread agreement that the New England Journal of Medicine is the world’s most prestigious medical journal, probably followed by the Journal of the American Medical Association. But The Lancet is probably in the top five.

2. The Lancet has officially classified fluoride . . .
The Lancet is not an endorsement organ. It publishes scientific studies. In this case, it published a study that mentioned possible fluoride toxicity. There is no “official classification” going on here.

3. . . . classified fluoride as a neurotoxin.
Here they are close, but again they are shading the truth. The study talked about “developmental neurotoxins,” which is different from “neurotoxins.” The difference is that the article discussed the effect of certain substances on developing human fetuses. Fetuses are especially sensitive, and some chemicals that would be perfectly safe for adults and children can damage unborn children.

4. The study didn’t actually examine fluoride. The author of the study only referenced data available from China that showed that Chinese children residing in areas with high fluoride concentrations had slightly lower IQs than children in other areas, presumably in areas with normal fluoride concentrations. But Hoppman shades the results to implicate ALL fluoride, not elevated levels of fluoride.

5. The conclusion of the study was that more research is needed – it wasn’t definitive.
That is only fair, given the thinness of the correlation they found in these Chinese children. Maybe these communities in China had elevated fluoride in the water because they had poor water systems or the residents were poorly educated (hence the lower IQs of their children) or had other problems. Every serious scientific researcher understands the difference between establishing a correlation and establishing that one parameter causes the other. And since this research article only reported on these other studies, there is no opportunity here to critically examine those studies. That’s why the study author was rather tentative about his conclusions with regard to fluoride.

Stoking Fluoride Fear

So, with a generous amount of exaggeration, stoking fluoride toxicity fearsHoppman helps stoke fears of fluoride. Fluoride, let me repeat here, is a natural mineral that is present in most natural water sources. When I practiced in Iowa, I had patients from rural areas who had well water, and I would ask them to bring in samples of that water and send it in for analysis of its fluoride content. Every sample had some fluoride in it. And the research establishing that the presence of the mineral fluoride in water in certain very low concentrations helps during formative years to build teeth that are more decay-resistant, that research is solid. Unethical fear-mongerers like Hoppman cause their share of damage.

The real poison in our drinking water is chlorine, and it’s curious that fear-mongerers like Hoppman choose instead to go after fluoride. Chlorine kills bacteria and other pathogens and is one one the reasons the water supplies in this country are among the safest in the world, but it is a poison. Fluoride, on the other hand, is a beneficial mineral nutrient.

My recommendation—be at least slightly skeptical of every sensational-sounding news article addressing medical or dental information. Don’t stray from solidly established principles without repeated evidence from various sources.

– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 5, 2013

Dental New Year’s Resolutions

Filed under: Preventive Dentistry — Tags: , , — mesasmiles @ 5:09 pm

Here are some New Year’s resolutions suggestions from our dental hygienist:

I am trying to get healthier and have changed some diet and exercise habits this year. Since I am doing so well, I would like to add some dental resolutions to my list. What would be the top three resolutions to add?

Thanks, Cynthia

Dear Cynthia,

I commend you for trying to improve your overall health. Change will come one resolution at a time. Since you did not state what your oral health habits are currently, I am going to give you the top three for anyone.

1. Brush 2 to 3 times a day for at least two minutes and floss daily. Watch a video online about the correct toothbrushing and flossing techniques. Small changes in your technique can reap many rewards. Explore the option of an electric toothbrush. (A sonic toothbrush such as Sonicare comes highly recommended.) A basic one is all you will need and they are very effective. Most of them have timers to help you with your two minute resolution.
2. Make an appointment to see your dentist. An exam and professional cleaning will go a long way in making sure that any small problem does not get out of hand. Request an oral cancer screening if one is not done. The dental professional is trained to detect small changes in the mouth. Early detection is extremely important as only half of the patients diagnosed with oral cancer will survive more than 5 years.
3. Add an over-the-counter anti-cavity rinse to your home care routine. There are several choices but make sure that they contain sodium fluoride. It is a simple inexpensive way to decrease your risk for cavities. Some studies have found a reduction of up to 71% in decay when used as directed.
Good luck and may you continue to reach your goals in the upcoming year.

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

June 15, 2009

Feeling pushed into treatment

Filed under: Preventive Dentistry — mesasmiles @ 4:24 pm

I am a senior with limited income and recently had a vizilite solution performed by my new dentist’s employee. It cost $59.00 and they way it was pushed on me I feel their tactics indicate I wasted my money. Am I correct? Also for my next appointment they want to do a deep cleaning at a cost to me of $113.00. How can I determine it is necessary as dental insurance only covers a normal cleaning not deep. Thanks for a prompt reply.
– Joe from Florida

Joe,
Your concerns about being pushed into choices by your dental office sound justified. I know how you feel–you’re in a vulnerable position of needing to trust your dental office, and then you get pushed into add-on tests and services that you’re not sure you need.

The ViziLite is an excellent screening tool for oral cancer, but if I were on a tight budget, I think I’d skip it if it were going to cost me $59. The deep cleaning may be needed. But if they were pushy with me on the one issue, it makes me more skeptical.

If you are finding that you have a problem trusting your dental office, I would go shopping around for another dentist. There is no way for you to check up on them to make sure you need everything they say you need, so it all comes down to trust. In my opinion, dentists as a rule are very ethical, but there are some who are not trustworthy. And this pushiness is a red flag to me.

– Dr. Hall

Click here to ask Dr. Hall a question.

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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