The Forum on Fluoridation:
An Exercise in ‘Truth Decay’.
An Investigation into the ‘Fluoride Bias’ Endemic within the Minister’s Forum
In May 2000, Minister for Health Micheal Martin set up a Forum to investigate the controversial health programme of adding chemical fluoride to Ireland’s drinking water supply. This move came in the wake of increased media coverage of the possible health damage associated with water fluoridation. In addition, reports alluded to the disquieting evidence that Health Board’s had intimidated an Irish dental professional who had been using the Freedom of Information Act 1997 to establish the origin of Ireland’s chemical fluoride. These claims of intimidation were upheld by an Ombudsman investigation, but why did Public Health Professionals resort to threats and intimidation?
Rebuking allegations that his Fluoridation Forum was set up to deflect attention away from the real debate, and was populated by pro-fluoride supporters, the Minister described his motivations for the Forum’s inception as follows; "I felt it was important to give all perspectives the opportunity to articulate their views in the context of a Forum which will be objective, independent." Mr Martin repeatedly referred to "the open nature of the Forum".
However, a mere cursory glance at the make-up of the Forum’s membership points to the fact that this ‘hand-picked’ body of professionals is a mere who’s who of Ireland’s pro-fluoridation lobby. In fact some of the members were actually instrumental in introducing this health programme to Ireland in the early 1960’s.
Is it conceivable that the Forum on Fluoridation will now make any concession that would question their professional integrity over the past 40 years? After promoting a questionable health programme that is based on unsound science, is unethical and undemocratic, will the Forum now legitimise any genuine concern that would cast serious doubt over their professional judgement? Not likely. In fact, a brief analysis of the Forum’s membership points to an inherent bias that possibly borders on corruption…
Who is on the Forum?
The Forum comprises 19 experts and professionals. The Department of Health’s fervent efforts to paint a picture of ‘objectivity’ and ‘open-mindedness’ within its Forum starts with the Chairman. The Forum believes that if it can prove that it has appointed an ‘independent’ Chairman, this will surely protect its credentials. Presumably the corollary of this argument will be accepted by the Forum in time…
The Forum’s website asks ‘Is there an independent Chairman?,’ and promptly kills the suspense by declaring unequivocally; ‘Yes. The Chairman of the Forum is Professor Pat Fottrell, former President of the National University of Ireland, Galway, who has extensive relevant knowledge and experience but who is not engaged in any way with the practice of fluoridation.’ However, it is with the top man himself that the Forum’s tangled web of fluoride bias and intrigue begins to unfold…
(1) Professor Patrick Fottrell. Chairperson. National University of Ireland, Galway.
Professor Fottrell is a former president of University College Galway (N.U.I.G.). Following a change in government legislation, N.U.I. Galway set up the Galway University Foundation to generate private funding for new capital projects.(1) Professor Fottrell has some interesting connections.
The First Annual Report of Galway University Foundation shows that Board Members include Dr. Patrick Fottrell and businessman Thomas McDonogh (Thomas McDonogh & Sons).(2) Thomas McDonogh is the chairman of The McDonogh Group - one of the largest private companies in Ireland, with factories throughout Ireland, producing fertilisers, animal food stuffs and water treatment chemicals. He is also a director of over 20 companies.(3)
Interestingly, The McDonogh Group owns Albatros Fertilizers Ltd., New Ross, Co. Wexford, the suppliers of the fluoridating agent, hydrofluosilicic acid.(4,5) In 1998, Albators received £340,226.00 from the Eastern Regional Health Authority (ERHA) for supply of this fertiliser waste product to all the water treatment plants in Ireland. This chemical fluoride is pumped into our drinking water at the rate of 2000 gallons daily. As if to eliminate any possibility that these two Board members may be unknown to each other, in June 2000 Dr. Fottrell was among staff members who proposed Thomas McDonogh for an honorary doctorate (LL.D.).(6) There should be a serious concern that this constitutes an undeclared competing interest for the chairperson of the fluoridation forum, with such cosy connections making a mockery of the Department’s assertion that their chairman is 'not engaged in any way with the practice of fluoridation'.
(2) Dr. Gerard Gavin, Chief Dental Officer, Department of Health.
One of Ireland’s main keepers of the Fluoride Faith is the Department’s Chief Dental Office. Dr. Gerard Gavin was instrumental in the Dental Health Action Plan (1994).(7) This plan intends to "[i]ncrease efficiency and number of water fluoridation schemes."(8) Dr. Gavin recently demonstrated his openness on this subject, "[w]e consider fluoridation safe at the levels it is being used in Ireland and of great benefit in the treatment of dental caries."(9) He also recently proclaimed that, [i]f we can change our prevention habits, in terms of how we look after our teeth we may not need water fluoridation in the future."(10) This may mean that if we are all good boys and girls and brush our teeth properly we just might be spared further fluoride ingestion!
(3) Professor John Clarkson Dean, Dental School and Hospital, Trinity College, Dublin.
(4) Professor Denis O Mullane, Oral Health Services Research Centre, UCC.
The two professors are the two most highly qualified dental academics on the fluoridation forum. They have worked together before on many fluoride projects.(11)
Professor John Clarkson, currently Dean of Dublin Dental Hospital, was previously president of both International Association Dental Research (IADR) and American Association of Dental Research.(12) The IADR, not surprisingly, "fully endorses and strongly recommends the practice of water fluoridation for improving the oral health of nations."(13)
The IADR receives funding from Unilever and they co-present awards.(14) In addition, the "IADR-Dental Faculty has been made possible and is supported through an educational grant from Unilever Dental Research".(15) Unilever is a multi-national pharmaceutical firm producing fluoride toothpastes e.g. Mentadent, Signal and Close-up.(16)
Both Clarkson and O Mullane have promoted fluorides/fluoridation around the world for several years. In 1997, they opened the World Congress on Preventive Dentistry in South Africa with "Trends and developments in fluorides and fluoridation" which included the "[c]ost-effectiveness evaluations of fluoridation strategies".(17) Interestingly, this conference was sponsored by IADR and funded by Colgate, another fluoride toothpaste multi-national. In addition, Clarkson opened the 7th World Congress on Preventive Dentistry in Beijing in 2001.(18) The title of his presentation was, "Fluorides & their role in future preventive action" and the convention organised by IADR and sponsored by the fluoride triumvirate of Colgate, Procter & Gamble and Unilever.(19)
Professor Denis O Mullane, is also a member of IADR.(20) Surprisingly, he presents himself as "an independent objective research worker in the field of Dental Public Health" in a recent submission to the Dail Committee on Health and Children. However, he failed to mention that he has promoted fluoridation in Ireland and abroad for many years.(21,22) The British Fluoridation Society includes O Mullane on their information leaflets.(23) He is currently president of British Association for the Study of Community Dentistry (BASCD).(24) A recent conference in Cork, chaired by O Mullane, held an emotive debate on the effect of fluoride on hip fractures but speaker Prof Cyrus Cooper, professor of rheumatology at the University of Southampton, said he believed fluoridation was safe.(25)
Other connections include the British Nutrition Foundation (BNF). Professor O Mullane presented at a 1999 conference on Oral Health: diet and other factors.(29) The BNF was set up by sugar and pharmaceutical companies in the 1960s e.g. Tate & Lyle Ltd., Unilever PLC, Cadburys and Procter & Gamble.(30) A strange mix of fluoride and sugar. This organisation was also the subject of a recent BBC documentary, which suggested that BNF, despite its name, is a lobby group promoting the interests of sugar and pharmaceuticals multinationals around the globe. It is therefore no great surprise that on their Oral Health advice, fluoridation/fluoride is at No.2 with diet and sugar reduction displaced to No. 5.(31). Despite Professor O Mullane's profluoride bias, and his repeated denial that there are no health risks with this public health program, Minister Martin awarded O Mullane, on 27/2/2002, a five year grant estimated at 500,000 - 1,000,000 Euro to invesitgate the benefits and risks of water fluoridation.(32) If there are no risks why is O Mullane receiving this grant?
(5) Dr. Maire O Connor and (6) Dr. Howard Johnson, specialists in Public Health Medicine.
Dr. Johnson protests on the website of the Fluoridation Forum, that he "has no agenda on this issue and is proceeding on an open-minded basis".(33) However, he and Dr. O Connor co-authored the Faculty of Public Health Medicine (Royal College of Physicians) report "Water Fluoridation and Public Health".(34) The report, published in 1999, concluded, "the data available to date strongly supports the continuation of the current water fluoridation policies". This pro-fluoride conclusion appears to contradict his protestations.
After only two forum meetings Dr. O Connor also appeared to have made up her mind, "[a]t the moment the balance of evidence is such that water fluoridation continues to prevent dental caries and there’s no evidence other than dental fluorosis that it causes any harm to peoples health.". This comment recorded in a TV3 interview in November is interesting because Dr. O’ Connor reached such conclusions with ten scheduled forum meetings remaining!
(6) Dr. Carmel Parnell, the representative of the Irish Dental Association
Dr. Parnell also declares she "came to the Forum with a neutral attitude".(35) However, she represents an organisation that stated in June, "the Association would strongly support the continuation of the current water fluoridation policies".(36) In addition, Dr. Parnell was a member of a clinical examination team, which participated in a survey commissioned by the North Eastern Health Board in 1995. This survey stated, "(a)n even greater improvement in oral health could be achieved across the whole region by improving the effectiveness of water fluoridation schemes, as well as ensuring that where feasible, other schemes are fluoridated".
(7) Dr. Wayne Anderson representative of the Food Safety Authority of Ireland (FSAI).
A press release from the FSAI, in August 1999, advocates the use of tap water over bottled water for formula feed, "(m)ineral waters may have a high solute content, may contain inadequate fluoride and should not be used to mix formula or as an infant drink".(37) This appears to favour a pro-fluoride stance. However, following a recent risk assessment on fluoride which found, "that infants below the age of four months are exposed to doses of fluoride that exceed the recognised no observable effect level",(38) Dr. Anderson appears to contradict the 1999 statement. When questioned by the Irish Independent (27/2/2002) about overdosing bottle-feeding infants with fluoride he said parents should not be worried as "bottled water may have even higher fluoride levels than tap water". Two years ago bottled water had "inadequate fluoride" but now when the controversy is raging, "bottled water may have even higher fluoride levels than tap water". It seems Dr. Anderson will say anything to protect the status of water fluoridation.
(8) Dr. Joe Mullen representative of the Health Boards.
Dr. Mullen’s views on water fluoridation are well known. He recently co-wrote an editorial in the Irish Medical Journal summing up his ‘unbiased’ opinion, "[w]ater fluoridation is the most effective strategy to prevent decay as it reaches everyone, benefits all age groups and does not rely on compliance. It is our public duty and responsibility as health professionals to do our utmost to improve the dental health of all people and the continued support of water fluoridation should therefore be encouraged."(39)
He also wrote to the Irish Medical News to voice his further devotion, "the simple truth of the matter is that every single major review of the evidence, both medical and dental, has concluded two unarguable facts: (a) fluoridation benefits dental health and (b) adverse medical effects are unproven".(40) Dr. Mulllen also stated, "dentists relied on research from the most respected sources, such as the teaching universities, the WHO and the Centre for Disease Control and fluoride was "absolutely harmless" in the amounts put into the Irish water supply."(41)
It is difficult to understand how such opinions can be described as objective, independent or open.
(9) Mr. Kevin Moyles, Regional Public Analyst.
Although Mr. Moyles views on fluoridation are unknown, it would appear that he has been seriously eschewing any notion of transparency in relation to the issue. He has even knowingly misled the public on at least one occasion. An example of this occurred at a recent meeting of the Forum on Fluoridation (5/4/2001). At this meeting, closed to the public, Mr. Kevin Moyles, Head Public Analyst, stated that "…tests done so far by the Regional Analysts’ Laboratory suggest that the hydrofluosilicic acid (fluoridating agent) used is pure…."(42)
However citizens group Fluoride Free Water recently obtained a full chemical analysis of this acid under Freedom of Information Act 1997 from the Eastern Regional Health Auority. This confidential document (see attached analysis), dated 14/2/2001, was forwarded to Mr. Kevin Moyles but did not indicate the acid as "pure". In fact, one quarter of the H2SiF6 (acid) is contaminated, including carcinogens such as arsenic, chromium, nickel and mercury."(43) This brings into question the accuracy of Mr. Moyles comments on the fluoridating agent.
(10) Professor Miriam Wiley, Economic & Social Research Institute.
Professor Wiley works closely with Professor Denis O Mullane, and are project partners in EU funded research into Oral Health.(44) This research is commissioned at the Department of Oral Health and Development and the Oral Health Services Research Department, Cork University Hospital. The BIOMED1 and BIOMED2 programmes are investigating the "efficiency in the delivery of oral health care services; the measurement of fluoride absorption and ingestion from toothpaste by young children; and the development of a standardised method of recording enamel opacities." (45)
Another organisation that merits mention is the Dental Health Foundation Ireland. This a charitable trust(??) and is funded partly by the Department of Health. Their main mission appears to be the promotion of a simple message "Fluoridation of the public piped water supplies is the safest, most effective and most efficient method of preventing tooth decay."(46) They are major supporters of pro-fluoride publication e.g. they published Faculty of Public Health Medicine (Royal College of Physicians) report "Water Fluoridation and Public Health" as mentioned earlier.(47) They also held a conference in Cork last September entitled, "Promoting Oral Health in the 21st Century."(48) There were many supporters of fluoridation present including Dr. Gavin, Prof. O Mullane and Dora Henessey. Moreover,
(11) Professor Cecily Kelleher, Department of Health Promotion, National University of Ireland, Galway, also attended the conference.
Professor Kelleher recently gave a presentation on health promotion strategy, (49) reiterating that after "[e]xamining the goals of the 1995 Health Promotion Strategypertaining to oral health, Professor Kelleher identified the overall goal as one of improving the level of oral health in the general population. More specific objectives included:
Whilst perspectives from the above fluoridation promoters should undoubtedly form an integral part of any assessment on the safety and effectiveness of water fluoridation in Ireland, their contributions should be strictly categorised as ‘biased evidence’ in a debate with two sides. These professional should not also be accorded the status of judge and jury. With past recommendations proffered by these professionals being repeatedly used to reinforce the status quo that is mass-medication of the population through the water supply, attaining the capacity to be ‘objective’ and hold in abeyance any preconceptions is simply not possible.
In light of the type of overt bias displayed above, several groups and individuals who otherwise could have contributed valuable evidence to the Forum, have refused to attend to present their perspectives. Others walked away with grave concerns about the Forum. Dr. Andrew Rynne, General Practitioner and Medical Writer who attended the Forum expressed his own disillusionment, "[i]t was opened by the Minister of Health who announced to the attending media that fluoridation was the best thing since sliced bread. Then, just to make sure that we all keep eating it, the Forum is stuffed with pro-fluoridation heavy hitters – Professors, Chiefs, Deans and the like."(51)
The citizens’ organisation Fluoride Free Water rejected an invitation to the Forum. Dr. Don Mac Auley, dental advisor, stated, "[i]n my opinion it has a pronounced pro-fluoride bias and therefore is not a serious, independent or fair assessment of water fluoridation in Ireland."(52)
In conclusion, after analysis of the interests and associations of several Forum members, it is difficult to affirm that they are all individually objective, independent or open. The question must be asked, are they in their privileged positions within the Forum to protect ‘public health’ or to protect 'public health policy’?