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Current Affairs Science

Lush throw science out with the bath water

Facebook post from Lush Cork advertising their charity pot party event.This week, Lush found themselves the subject of some controversy when they posted a message about an upcoming charity pot party supporting the Girl Against Fluoride. In an event that spanned Friday 24th to Sunday 26th, Aisling FitzGibbon, aka the Girl Against Fluoride, was to appear and discuss her opinions on water fluoridation, and potentially (as implied by the charity element) raise money for her campaign. When the event link appeared on Facebook, something really beautiful happened: people came, and almost unilaterally sent Lush a message – we support science, evidence, and reason, and if you don’t then we will take our business elsewhere.

It really cheered me up to see (especially in wake of Dublin City Council’s questionable decision regarding water fluoridation) that the large majority of the people commenting were shocked that Lush would support someone who appears to ignore science, and subscribe to a lot of dangerous, disproved, or just downright insulting beliefs. Not only is the Girl Against Fluoride against fluoride, but she’s also apparently not a fan of vaccines, real medicine, or gay people, and commenters took her, and Lush, to task over these points and more.

RebeccaLush1After a significant number of commenters both on Facebook and Twitter called for Lush to make a statement about the event, their charitable giving manager Rebecca Lush weighed in to ask for some evidence about the points that people had raised – but only about the homophobic comments made by Girl Against Fluoride’s creative manager and mother, Martha Brassil. Rebecca went as far as to say that she wasn’t looking for information on the science behind the anti-fluoride campaign, just evidence of the homophobia.

Several commenters obliged Rebecca and Lush with evidence of the homophobic comments, and we began a long wait for Lush to comment. With the start date of the event drawing closer, Lush would only say that they were close to releasing a statement, and that they wanted to get it right, and verify it with various internal groups before releasing it. On Thursday, a comment from Lush confirmed the outcome that many had hoped for. Lush would not be hosting or raising money to support the Girl Against Fluoride. However, as the saying goes, every silver lining has a cloud…

RebeccaLush3

Lush may have cancelled the event, but not because they care about the bad science or scaremongering that characterises the anti-fluoridation campaigns, but because the homophobic comments made did not sit well with their commitment to gender equality and anti-homophobia stance. I commend Lush for standing up for LGBT rights and gender equality, two topics close to my heart, but this resolution leaves a lot to be desired. They may disagree with the homophobic comments, but they share the Girl Against Fluoride’s views on water fluoridation and apparently wish to have a reasoned debate about the issues surrounding it (without, to my knowledge, actually consulting any scientists about it). It’s good that Lush examined the homophobic comments made in the name of the Girl Against Fluoride, but the science matters too, and it should be just as important a reason to reconsider this event.

It’s becoming increasingly common to try and balance out scientific input with something fluffier but inaccurate, because people often perceive the “truths” of science as harsh. It seems cruel to tell someone “you’re wrong”, and easier and friendlier to tell someone “everyone will have time to express their equally valid opinion”. And if we were discussing fabric samples for the living room curtains, that would be lovely, but we’re not. We’re discussing a number of topics for which there is very well established information, and people who choose to ignore that information. The pill doesn’t cause women to have homosexual babies. Urine doesn’t cure cancer. Vaccines don’t cause autism. And water fluoridation is an important public health measure that is safe, effective, and considered one of the most important health measures of the 20th century. Maybe it’s not as sexy or interesting to discuss the facts like this, and perhaps it would be better received if I, too, posed in a bikini, but the really beautiful thing about facts is that they are true, whether or not you like them or believe in them.

I’ve discussed the problem with applying “balance” to these situations before, but it boils down to a very simple message: while everyone can have their own opinion, everyone can’t have their own facts, and when a group misrepresents facts (or just outright lies) and is given airtime the same as groups which actually represent the evidence for the sake of balance, it lends them a legitimacy that they do not deserve. The Girl Against Fluoride does not deserve this legitimacy. She believes a number of dangerous and damaging things, and actively spreads misinformation about fluoride (among other topics). Hosting her doesn’t encourage discussion of different points of view, it lends the support of a brand to her point of view and her point of view alone, especially when they host her alone (and not her in conjunction with any one of a number of qualified people who could provide the other side of that balance they seem eager to seek).

It might not be popular to stick up for science in a climate where words like “natural” are venerated, and words like “chemical” are decried (whatever their actual meanings!), but that doesn’t make the facts go away. When good, robust evidence shows me that it is better to remove fluoride from our water, I will support that change. Until then, I will continue to trust the overwhelming evidence in favour of water fluoridation, I will continue to be the Girl Not Against Fluoride*, and I will continue to promote science above populist scaremongering and misinformation.

 

*I still won’t pose in my bikini though.

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Current Affairs

Girl Not Against Fluoride

The CDC (Centre for Disease Control) lists water fluoridation as one of the ten great public health achievements of the 20th Century. Today, Dublin City Council will vote on whether to remove fluoride from our water supply, and when they do, it will not be because the CDC or the WHO have changed their mind about fluoridation, or because new and compelling information makes it the only choice. It will be because people who believe in angel healing, homeopathy, and chemtrails, have somehow gained the ability to influence public policy.

It never ceases to amaze me that, in matter of public health, the debate is more often informed by people who believe everything they read on the internet. Celebrities with a cause-du-jour and an audience are given more time and attention than scientists, doctors, or even just people who understand basic chemistry, and realise that not all scientific papers were created equal. It leads to invented medical scandals (such as the disproven MMR autism link), and poor decisions (such as the one the council may make tonight), and it’s really past time that it stopped.

The past few weeks have seen a number of claims made about fluoride, and I’ve been doing my best to counter them with evidence as they’ve appeared. Here are some of the most common issues presented to me every time I post a tweet using the word fluoride.

Is fluoride damaging our health?

In brief, all of the best evidence says no. Dental fluorosis is the most common side effect from fluoridated water, and it is almost always solely cosmetic. Lots of claims have been made about fluoride affecting brain development, affecting IQ, affecting bone growth – and all of these claims just don’t really apply to water fluoridation. Studies which claim to show adverse effects of fluoride are typically using concentrations of fluoride far higher than what is permitted in our water supply, and the concentration in our water supply is monitored. In high concentrations, fluoride absolutely can cause significant health problems, but these concentrations are hundreds of times more than what is currently in our water supply.

What about these countries that don’t fluoridate?

There are lots of reasons that a country may not fluoridate their water. In some cases, it is because they fluoridate alternatives, such as milk or salt (e.g. Germany, Switzerland). In other cases, it is because their water is naturally fluoridated (e.g. France, Argentina, Mexico, and many more). In still more cases, it is because the government has decided to approach dental health in a different way. No countries have yet decided to ban fluoridation because the angels told them it was a form of mind control, although Ireland seems to be teetering on the brink of gaining this dubious title.

This country doesn’t fluoridate, and their dental health is fine. What gives?

Systematic reviews (large studies which look at all of the data available) have concluded that water fluoridation results in a fewer children presenting with cavities, decreased decay, fewer missing teeth, and have concluded that it is responsible for significant cavity prevention across the population. But dental health is not a single point issue – many factors affect dental health, and water fluoridation is just one of them. Countries which have excellent dental health without fluoridation also typically have very robust dental health programs, providing free or inexpensive dental care for children, ensuring that they see dentists regularly, thus keeping the cavities down without fluoride.

More studies have also shown that dental health is highly linked to socio-economic status – in other words, families who cannot afford regular dental care, and do not have it provided for them by the state, tend to have more dental problems. Without fluoridation (and given no alternative), these families are disproportionately affected.

Water fluoridation is not a silver bullet for dental health problems, but without a dental health system which allows equal access to effective care (through school programs, subsidised or free care, etc.), it is one of the best solutions we have. Removing water fluoridation without implementing one or more solid alternatives is a recipe for disaster.

It should be my choice to fluoridate. I don’t approve of mass medication.

The mass medication issue is a tricky one, and like a lot of ethical issues, it is far from black and white. You could argue that a government has a responsibility to protect the health of its people, and that it should provide dental health care to do so (because poor dental health affects many areas of an individual’s life). And many people believe that it would be better if a government provided this through improved dental care system, and I’m inclined to agree. Where that cannot be provided, however, what is a government to do? Fluoride has been shown to help dental health, and if you agree that a government has a responsibility to do its best for the health, life, and wellbeing of its people, shouldn’t they use it?

Mass medication is an ethical dilemma– even if it is shown to benefit people, and cause little or no harm. It is a debate that needs much consideration, but it is a debate that deserves better than scaremongering tactics, false information, and outright lies.

(Edit: 1/10/14 – edited to add some some supporting info: in a 1965 court case, the Supreme Court decided that water fluoridation did not constitute mass medication. The term is inaccurate, and designed to scare people, and used here only because it is the term that will be used most often by those who oppose fluoridation. Water fluoridation is water treatment, not mass medication.)

The fluoride debate is an emotive issue, and because of this, it will probably continue to be controversial. The controversy, however, merely makes it even more important that our politicians do not bow to pressure from scare-tactic groups and appeals to emotion, but decide based on the best available evidence. And that evidence is pretty clear – just ask the WHO, the CDC, the ADA…

My name is Jennifer Keane. I studied at Maynooth University where I was awarded my BSc, and then at the Open University, where I received my MSc. I’m passionate about the truth, about science, and about education. I’m the Girl Not Against Fluoride. I won’t pose in my underwear, but I do have my very own superhero costume. It is my graduation robes, because I am qualified.