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Paul Melters’ response to Billy Budd - Comment 48180 - Perrott Blog
December 9, 2013

COMMENT 48530     Paul Melters    December 10, 2013 at 10:27 am

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In COMMENT 48180, Billy Budd wrote:

BILLY BUDD: “One more point about Iida/Kumar (2009) vs Pontigo (2007). Not everything which appears as fluorosis on examination is fluorosis. This an important reason why the Mexican paper about fluorosis (Pontigo et al, 2007) at high elevation should not trump the very large well designed US study.”

PM RESPONSE: Absolute nonsense. As was already explained in a previous post, the Pontigo-Loyola data was also used in other publications, including one to assess the Dean fluorosis index. Methods are clearly stated:

“Dental examinations were performed by two examiners previously trained and standardized (kappa interexaminer=0.85; intraexaminer=0.97). A pilot study was conducted beforehand to standardize fluorosis criteria...Fluorosis was differentiated from other opacities [24].”

BILLY BUDD: “This point was well made in the 2010 EPA document Fluoride: Dose-Response Analysis For Non-cancer Effects p 10. The NRC (2006) also cautions that not all enamel defects are caused by fluoride. Citing Curzon and Spector (1977) and Cutress and Suckling (1990), NRC states that “Mottling unrelated to fluoride has been suggested to be due to malnutrition, metabolic disorders, exposure to certain dietary trace elements, . . . or physical trauma to the tooth.” Furthermore, there is some evidence that “hypobaric hypoxia that occurs at high altitudes is associated with bilaterally symmetrical and diffuse disturbances in enamel mineralization that may be mistaken for fluorosis.”

PM Response: You took this from page 10 from the EPA document.

Talk about using material out of context. However - this is a good example how nonsense written in one report gets amplified in another...

The NRC section where this quote can be found was addressed in detail by the Canadian group PFPC in 2006:

If you find anything wrong with what is reasoned there, let me know. Quite the “experts” on those reviews, uh?

BILLY BUDD: “Changes visually identical to fluorosis would probably injure the enamel tooth structure but would not bring fluoride’s caries protection.”

PM RESPONSE: Again - absolute nonsense. That fluoride injures the enamel tooth structure is more than firmly established. Learn about dental fluorosis.

I suggest reading Rozier’s 1994 paper on this matter. It’s is very difficult to take your BS here seriously.

BILLY BUDD: “High elevation, potential malnutrition, and other potential causes of symmetrical white enamel abnormalities argue that the large well-designed study correctly found that in the economically advantaged world, fluorosis prevents cavities.”

PM Response: Again - learn about dental fluorosis. Read Rozier, 1994. Or, even better - Russell, 1961. Address the many papers that show dental fluorosis increases caries.

Stop pretending that you actually know something about this. You are a troll.

The large “well-designed study” by Iida and Kumar will be addressed separately.

Paul Melters

Rozier RG. Epidemiologic indices for measuring the clinical manifestations of dental fluorosis: overview and critique. Adv Dent Res. 1994 Jun;8(1):39-55.Review. PubMed PMID: 7993559.

Russell AL. The differential diagnosis of fluoride and non-fluoride enamel opacities. J Public Health Dent 21:143–146 (1961)