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More censorship and blog manipulation by Ken Perrott

Nov. 26, 2013

  Today I received two PDFs from Louise Mantella in Australia, who had spent considerable time in the last few days posting on Perrott’s blog, presuming that there was a real “scientific” debate going on.

  The PDFs contain communication between Mantella and Perrott, as well as some other familiar “experts” such as Billy Budd, and Steve Slott.

  As Wordpress allows posters to see their own comments, regardless if they are disallowed (“awaiting moderation”) or not, these two PDFs show once again how Perrott manipulates the comment section on his blog. (Normally, other readers are not able to read the comments which are marked “under moderation” in the PDFs.)

  It certainly appears that Ken Perrott has no real intention what-so-ever to address this issue with integrity.

  He now has stooped to a new low by disallowing a comment - just to make the conversation look like Mantella was confused, while in fact it is Perrott needing some Psych evaluation. First claiming that fluoride in apatite “lowers solubility”, then claiming a “deficiency lowers solubility”. Quite the chemist we have here!

(Although many dental experts proclaim fluoride to be essential - including the “experts” at the CDC Oral Health Division - fluoride is NOT essential, and there is NO such thing as fluoride deficiency.)

PDF

  As Louise writes in her email, of special interest is the following:

1) Perrott continuously avoids the issues under discussion. He fails to provide a scientific reference for his statement:

    “If deficient the bones become weak and have a lower solubility”

  In Comment 47753 he starts misinterpreting Mantella’s words and manipulates the exchange. He moderated/censored comment 47746 - apparently for no other reason other than he looked bad in it - and then goes on as if it didn’t exist. In another post Perrott accuses Mantella of “sloppy use of references”, but then - by moderating her comment - disallows her response to this allegation, in which she also requests the reference once again - very specifically.

  Perrott then later claims that Mantella is confused and that he doesn’t understand what specific “deficiency claim” reference she is looking for.

2) Perrott does not supply a study that can demonstrate pre-eruptive benefits of fluoride (from the review by Newbrun), as was requested.

3) Perrott entirely distorts the dental fluorosis issue, proclaiming that the quotes and references “sort of suggest the association is with more serious forms of dental fluorosis”. Mantella’s quotes and references were entirely clear - both quotes from the Mexican studies show that caries incidence AND intensity increases with very mild and mild dental fluorosis.

  Below is the entire exchange between Perrot and Mantella, as is documented in Mantella’s PDF. (To see all in context, as well as other exchanges, especially between Billy Budd and Mantella - please see the PDF. Mantella addresses all of Billy Budd’s nonsense.) It is also posted here.

It is no wonder Mantella has no further interest in a sham “scientific” discussion.

COMMENT 47705  Louise Mantella   November 25, 2013 at 11:03 pm |

Dear Ken

It would be great if you could provide references for these statements, so that one may look it up.

Here are a few quotes from various reviews, for you to consider:

“Assuming that more fluoride in the enamel would provide a greater anti-caries protection, measurements of fluoride in enamel have been undertaken by many authors. However, most of these studies failed to clearly demonstrate an inverse relationship between fluoride enamel content and caries prevalence.”
(Arends & Christoffersen 1990; Duckworth & Gilbert, 1992, Feyerskov et al, 1981)

“No significant relationship has been demonstrated between caries experience of the individual and fluoride content of the enamel. Furthermore, the fluoride content in surface enamel between teeth developed in low and “optimal” fluoride areas is too small to explain any significant effect on dissolution rate of the enamel.” (Feyerskov et al, 1981)

“It is concluded that even shark enamel containing 30,000 ppm F has a limited resistance against caries attacks.” (Oogard et al, 1988)

“However, more recent studies suggest that fluoride present in the surface enamel does not significantly prevent acid production. The concentrations of fluoride present in the saliva are too low to affect bacterial metabolism.”(Rosin-Grget, 2001)

“Nevertheless, fluoride tablets continue to be prescribed as if the action of fluoride is expressed systemically.”(Bowen, 1991)

“Thus, efforts to increase the fluoride content of dental hard tissues by systemic or topical fluoride are not a logical approach to caries prevention.” (Fejerskov et al, 1981)

“The lack of benefit of pre-eruptive systemic fluoride application has been shown by Reich et al, who performed a prospective study in newborn children. The authors demonstrated that there was no difference in caries development at the age of 5 years if fluoride was administered as tablets right after birth as opposed to an application starting in the age of seven months, i.e. with the eruption of the first decidious tooth (Reich et al, 1992)” (Zimmer et al, 2003)

L

COMMENT 47718 Ken November 26, 2013 at 7:07 am

Louise, could you pleases provide full citations when you refer to an article or publication - preferably a link if you have it. For two reasons:

1: I always like to check out originals - there has been too much selective quoting in discussions on this issue.

2: Without details these quotes begin to look like simple copy and paste where the commenter as not even bothered to check the article themselves. Of (sic) so - why should I bother.Especially when I haveli (sic) do all the hard work of hunting it down.

I will comment specifically on your quotes when I have time to check them out. There are some family and health priorities today.

COMMENT 47724 Louise Mantella  November 26, 2013 at 9:42 am

Dear Ken

‘Louise, could you pleases provide full citations when you refer to an article or publication’

No problem Ken.

Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res 69:601-605 (1990)

Bowen WH. Caries prevention-fluoride: reaction paper. Adv Dent Res 5:46-9 (1991)

Duckworth RM, Gilbert RJ. Intra-oral models to assess cariogenicity: Evaluation of oral fluoride and pH. J Dent Res 71:934-944 (1992)

Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries prevention. A concept based on possible cariostatic mechanisms. Acta Odontol Scand 39(4):241-9 (1981)

Reich E, Schmalz G, Bergmann RL, Bergler H Bergmann E. Caries incidence in children after varying periods of fluoride tablet application. Dtsch Zahnartz Z 47:232-234 (1992)

Rosin-Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)

Zimmer S, Jahn KR, Barthel CR. Recommendations for the use of fluoride in caries prevention. Oral Health Prev Dent 1(1):45-51 (2003)

L

COMMENT 47729   Ken   November 26, 2013 at 10:38 am

Louise, going back to your previous comment. I do not know what you refer to when you ask that I provide references for statements.

You may be referring to my brief section in the last article about the composition of bioapatites and the systemic effect of fluoride. This really goes back to a section in my previous article (look for references there) - it was only mentioned again because Paul ignored it. Presumably you will find the references you want there.

You seem to be relying in the current understanding of the surface mechanism operating with existing teeth. This is a surface effect and relies in F in saliva and biofilms. It is the major effect for countering the acid- mineralisation reaction leading to decay.

However, beyond that there is known to be a beneficial effect from the ingestion of F in Pre-erupted teeth. this has been shown to reduce certain types of cavity.

There is a bait and switch deception going on here. Just because the evidence shows the predominant influence of the surface reaction with existing teeth does not remove the evidence showing a beneficial effect of ingested F on pre-erupted teeth.

And don’t forget your bones.

COMMENT 47739   Louise Mantella   November 26, 2013 at 11:51 am  |

Dear Ken

‘I do not know what you refer to when you ask that I provide references for statements.
You may be referring to my brief section in the last article about the composition of bioapatites and the systemic effect of fluoride. This really goes back to a section in my previous article (look for references there) - it was only mentioned again because Paul ignored it. Presumably you will find the references you want there.’

Yes, that was the section I was referring to. I just had a look at the previous article, but could not find supporting references there as well.

‘You seem to be relying in the current understanding of the surface mechanism operating with existing teeth. This is a surface effect and relies in F in saliva and biofilms. It is the major effect for countering the acid- mineralisation reaction leading to decay.’

The current knowledge indicates that fluoride benefits, if any, are occurring once caries is already present, hence have nothing to do with ingestion of fluoride before teeth erupt. Incorporation of fluoride into sound enamel is possible only as a result of concurrent enamel dissolution (caries lesion development) (Bruun and Givskov, 1999; Feyerskov et al, 1994; Rosin-Grget, 2001; White 1990).

Bruun C, Givskov H. Calcium fluoride formation in enamel from semi- or low-concentrated F agents in vitro. Caries Res (2):96-9 (1993)

Fejerskov O, Larsen MJ, Richards A, Baelum V. Dental tissue effects of fluoride. Adv Dent Res. 8(1):15-31 (1994)

Rosin-Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 25(2):703-12 (2001)

White DJ, Nancollas GH. Physical and chemical considerations of the role of firmly and loosely bound fluoride in caries prevention. J Dent Res 69 Spec No:587-94 (1990)

‘However, beyond that there is known to be a beneficial effect from the ingestion of F in Pre-erupted teeth. this has been shown to reduce certain types of cavity.’

I would like to have a look at the scientific evidence in support of this.

I had hoped you would address the papers I had referenced above. There is ample evidence that this is not so.

‘There is a bait and switch deception going on here. Just because the evidence shows the predominant influence of the surface reaction with existing teeth does not remove the evidence showing a beneficial effect of ingested F on pre-erupted teeth.’

Again - I would like to have a look at this evidence. If you could provide some studies for me to look at, that would be great.

‘And don’t forget your bones.’

If you believe that fluoride is beneficial on bone, then you must also accept the mechanisms by which this is thought to be so, such as via effects on enzymes such as phosphatase, G proteins, and so on. There are several good reviews available on this subject, such as Susa, 1999 and Lau, 1998. It has very little to do with fluoride stored in bone. On the other hand, the amounts of fluoride in bone correlate directly to the three stages of skeletal fluorosis.

Susa M. Heterotrimeric G proteins as fluoride targets in bone (review). Int J Mol Med 3(2):115-26 (1999)

Lau KH, Baylink DJ. Molecular mechanism of action of fluoride on bone cells. JBone Miner Res 13(11):1660-7 (1998)

L

COMMENT 47740   Ken    November 26, 2013 at 12:04 pm  |

Louise -best you specifically state what is troubling you - there are a number if citations there but you must be confused about something else.

You seem to want to interpret descriptions of the specific action of F in saliva in reducing mineralisation and encouraging remineralisation as some sort of evidence against the systemic benefits. I will just repeat Newbrun (2004) (but other commenters here have produced other references for you to check.

“The role of systemic fluoride in caries prevention is neither “minimal” nor “of borderline significance.” On the contrary, it is a major factor in preventing pit and fissure caries, the most common site of tooth decay. Maximal caries-preventive effects of water fluoridation are achieved by exposure to optimal fluoride levels both pre- and posteruptively.”

Fluoride is good for bones (within reason - skeletal fluorosis is a result of excess) as I have discussed in the article. It is a natural and normal constituent of bioapatites. If deficient the bones become weak and have a lower solubility. This is a basic chemical effect which I have now described several times in these articles. But it is a bit of chemistry Paul seems to want to avoid.

COMMENT 47743   Louise Mantella     November 26, 2013 at 12:31 pm |

Dear Ken

‘Louise - best you specifically state what is troubling you - there are a number if citations there but you must be confused about something else.’

Why must there be something troubling me? I am not confused about anything. I have provided you with much evidence from dental publications that there are - at best - only minimal systemic beneficial effects of fluorides on caries. I have provided you with some excellent reviews on the matter. I have included studies done on children which show no pre-eruptive benefit.

You are citing a statement from a review by Newbrun. Would you please be so kind and provide an actual
study? Please pick any study reviewed by Newbrun which you feel best provides proof for this pre-eruptive benefit.

I already have addressed the references from other commenters.

‘If deficient the beans (sic) become weak and have a lower solubility.’

Would you please provide a reference for this statement?

L

COMMENT 47745   Ken    November 26, 2013 at 1:06 pm 

Louise, you specifically asked for references but won’t tell me what specific point you want them referring to. I think I have done my best with this. You must have made a vague comment which you now can’t back up.

I have already been into the nature of apatites (our bones are bioapatites, as are our teeth)and the role played by F in natural apatites. You continual “please provide a reference” is an attempt to ignore what has already been put in front of you.

Do you deny the fact that F is normally and naturally part if the apatite composition?

Other commenters here have thrown back at you your sloppy use of references to support a belief you want to passionately hold on to.

COMMENT 47746 Louise Mantella | November 26, 2013 at 1:28 pm |

Your comment is awaiting moderation.

Dear Ken

‘Louise, you specifically asked for references but won’t tell me what specific point you want them referring to. I think I have done my best with this. You must have made a vague comment which you now can’t back up.’

I am puzzled. I thought this was about science? What am I not able to back up?

You are accusing me of “Sloppy use of references”? Just where do you find this “sloppiness”?

Did I not address the other commenters?

Let me be as clear as I can:

I would like a reference for this statement:

‘If deficient the bones become weak and have a lower solubility.’

I have never, ever heard of a fluoride deficiency in bone – hence my request.

Are you not able to back up your claim?

I also asked you for one study reviewed by Newbrun – whose review you cited – one that best documents – in your opinion – the pre-eruptive benefit you claim exists.

I thought all that was perfectly clear.

L

COMMENT 47753

Let’s see if we can get this straight, Louise.

You say that you are concerned with my statement on the natural involvement of F in bioapatites. Sepcifically (sic) you quote:

“Fluoride is a normal, natural component of bioapatites. In the real world these don’t exist as end-member compounds such as hydroxylapatite or fluoroapatite. They are more correctly described as hydroxyl-fluoro-carbonate-apatites.Accumulation of fluoride, together with calcium and phosphate, in our bioapatites is a normal part of development. This is beneficial because it helps strength our bones and teeth, and lowers their solubility.Both insufficient fluoride, or excess fluoride in our bioapatites can cause problems.Excessive dietary intake can result in excessive fluoride in our bones and teeth. Insufficient intake may also cause our bioapatites to be weaker and more prone to dissolve. When dietary intake of fluoride is reduced fluoride can be lost from bones and calcified tissues.The scientific literature reports that fluoride has a systemic role benefitting bones and pre-erupted teeth.”

Now that is a brief statement, intentionally without references, because Paul Connett had ignored the section of my previous article,Apatites contain structural fluoride, dealing with this issue. I was bringing it back to his atten6tion (sic). It is clear one needs to refer back if one has not read the previous article.

You seem to want to reject this chemical point, Louise, and nothing will deter you from that path. Yet it is a basic issue.

I realise that anti-fluoridation activists work hard to deny a systemic role for ingested fluoride. They also work hard to try and convince us the surface mechanism operating on existing teeth amounts to “topical application” and therefore deny a role for fluoridated water.

However, if you want to go along that path then you will need to produce evidence that the chemical understanding of apatites is incorrect. And, please, don’t rely on referring to the high concentration regions where we all know the situation is different (this is waht (sic) is happening when one drags in marked dental fluorosis).

Please correct me on my chemistry if I am wrong.

COMMENT 47755  Ken    November 26, 2013 at 3:37 pm  |

Luouise (sic) - could you please stop being agressive (sic). Referring to the honest input of other commentors as ‘ignorant’ is not acceptable.

I will keep you under moderation and try to stop future comments which are like this.

COMMENT 47756   Louise Mantella     November 26, 2013 at 3:57 pm  |

Dear Ken,

You’ve been keeping numerous of my comments under moderation and disallowing, although there is nothing aggressive about them.

I refer to comment 47746, for example, still under moderation. It is becoming apparent that you cannot provide a reference for your ‘deficiency’ claim.

You refer to ‘high concentration’ regions. FYI - DF occurs at fluoride plasma levels of 0.2 mumol/L and above. And at what levels does fluoride inhibit caries?

If you are not interested in addressing this issue honestly and with integrity, then I am no longer interested in participating on this blog.

L

COMMENT 47758     Louise Mantella    November 26, 2013 at 4:16 pm |

* Correction - that should be 2 mumol/L.

COMMENT 47759      Ken    November 26, 2013 at 4:18 pm

Louise - see my previous comment - I am keeping you under moderation because of aggression. I think I have cleared everything I intend to now. And I have provided references in my articles for the points made, Enough of attempts at confusions.

Yes, there is a lot of sneaky behaviour by anti-fluoridation activists on dental fluorosis “another bait and switch “ a very wide defintion to get the large figures and then pull up reports of negative effects which occur in severe cases only.

COMMENT 47761      Louise Mantella     November 26, 2013 at 4:40 pm |

Dear Ken,

‘Yes, there is a lot of sneaky behaviour by anti-fluoridation activists on dental fluorosis “another bait and switch” a very wide defintion to get the large figures and then pull up reports of negative effects which occur in severe cases only.’

In post 47741 I have provided evidence from just a few studies showing that very mild to mild DF cause an increase in caries. How can you possibly refer to this as “severe cases” only? This shows that DF certainly is not of “cosmetic concern” only.

http://tinyurl.com/k5qcbaw

I have asked you for one reference for your deficiency claim, and you are continuing to evade this issue.

I am no longer interested in participating.

L

COMMENT 47764    Ken    November 26, 2013 at 5:52 pm  |

Louise, I think your anger is getting you confused. Your arguments over fluorosis and decay at high concentrations was with Billy, I think. But a look at the references and quotes (unfortunately it would be impossible for me to hunt down those journals to check them out - what about providing links to full text) does sort of suggest the association is with the more serious form of dental fluorosis. I would have to read the papers to make a more definite conclusion.

I asked you specific questions about the chemistry of apatites. After all, you had quoted my summary.

Do you disagree that F is a natural and normal component of the bioapatite structure?

Do you disagree that F in the apatite structure strengthens it and lowers the solubility of the apatite? (No I am not talking about excessive amounts of F).

This demanding from me of references is confusing. What specific “deficiency claim” are you referring to?

And please don’t put your confusion back on me. I not evading anything - I am trying to understand what you want.

=======================

How ridiculous - “I’m not evading anything”...Perrott knew exactly what “deficiency claim” Mantella was referring too, but by not allowing COMMENT 47746 manipulated the flow of information, attempting to make it something else completely.

This is called fraud - a deliberate deception.