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POINT 2: First Response by Steve Slott, DDS to Paul Melters - August 29, 2013

Paul

Ok, I did access the 36 year old report you seem so desperate to have evaluated. Here is the URL I repeatedly asked you to provide:

http://www.nap.edu/openbook.php?record_id=1780&page=372

Here is the entire paragraph, in its proper context, as found on page 372:

"Also a retention of 2 mg per day would mean that an average individual would experience skeletal fluorosis after 40 years based on an accumulation of 10,000 ppm in bone ash. However, these new estimates for fluoride in food are questionable; consequently, so are their implications. The values are suspect because of analytical problems. The diffusion method of Singer and Armstrong (1969a) was used with a colorimetric reagents, and false high values are obtained with this technique (Taves 1966).

Okay, so, first, they are speaking of fluoride retention, not intake. Second, as noted, the "new estimates for fluoride in food are questionable, consequently, so are their implications."
Third, they provide no reference on where this estimate for skeletal fluorosis was derived.
Fourth, this is a 36 year old report.

So, let's go to something just a tad bit more up to date:

"In skeletal fluorosis, fluoride accumulates progressively in the bone over many
years. Early symptoms include stiffness and pain in the joints. Crippling skeletal fluorosis is associated with osteosclerosis, calcification of tendons and ligaments, and bone deformities. There is an elevated risk of skeletal effects at fluoride intakes above 6 mg/day. These intake levels occur in many areas of the world because of naturally high fluoride levels in the groundwater, notably in the Rift Valley of East Africa and in China.

----INADEQUATE OR EXCESS FLUORIDE: A MAJOR PUBLIC HEALTH CONCERN
WHO 2010
http://www.who.int/ipcs/features/fluoride.pdf

Additionally:

"Several of the more recent reviews on the safety of fluoride intake have discussed skeletal fluorosis, which is extremely rare in the United States. Epidemiological studies in the U.S. of communities with naturally occurring fluoride in the water 3.3 to 8 times the amount in optimally adjusted water supplies found no evidence of skeletal fluorosis. Pages 45-47 of the 1991 Department of Health and Human Services document Review of Fluoride: Benefits and Risks discusses the topic of skeletal fluorosis topic in more detail and provides references. Only 5 cases of skeletal fluorosis have ever been reported in the U.S. In these cases, the total fluoride intake was 15 to 20 mg./fluoride per day for 20 years.

----HHS Information Quality Web Site

Information Requests for Corrections and HHS' Responses
--- http://aspe.hhs.gov/infoquality/request&response/1d.shtml

Steven D. Slott, DDS