“Optimal” Fluoride Level in Drinking Water now an Urban Legend

An interesting study. If considered carefully, it undermines the argument that addition of fluoride to drinking water is necessary. Indeed, the idea of an “optimal” level has become a myth.

Steinmeyer R. [Influence of natural fluoride concentration in drinking water on dental health of first class pupils in an area with enhanced fluoride content at the beginning of the 21st century]. Gesundheitswesen. 2011 Aug;73(8-9):483-90. doi: 10.1055/s-0030-1255076. [Article in German]

BACKGROUND: Since the end of the first half of the 20 (th) century it is well-known that fluoride concentrations in drinking water of about 1 ppm reduce the prevalence of dental caries by about 40-60%. This knowledge led to the fluoridation of drinking water during the second half of the 20 (th) century in many countries, including East Germany. Although the natural F (-) content in drinking water in Germany is usually very low, the eastern Eifel is one of the few larger areas in Germany with (nearly) optimal (0.7-1.0 ppm) or moderately enhanced (0.3-0.7 ppm) natural fluoride concentrations in drinking water. 30 years ago, in 1977, the caries prevalence of children of various age groups in the fluoride-rich areas of the eastern Eifel was established by Einwag to be about 40% lower than in adjacent fluoride-poor regions (0.1 ppm). Meanwhile fluoride has become available from many different sources for children of any age: e. g., toothpaste (with 500 ppm fluoride even for very young children who just got the first tooth), fluoridated salt, professional fluoride applications (paid by health insurances), the rising consumption of mineral waters (many of which have a fluoride content >0.3 ppm). This poses the question of the current influence of enhanced natural drinking water fluoride concentrations on caries prevalence in children.

METHOD AND RESULTS: The results of the dental examinations of 9 555 pupils (6 or 7 years old) of the first classes of all 63 primary schools in the Landkreis Mayen-Koblenz from 5 years (2004/2005-2008/2009) are compared to the fluoride content of the drinking water. The data show no obvious correlation between dental health and fluoride concentration for any of the dental health parameters investigated. However, in spite of the low geographic resolution of social parameters, there was a notable connection between dental health status and sociodemographic indicators for the respective region.

DISCUSSION: 30 years after the study by Einwag in the same region, the natural fluoride content of drinking water either had no influence on dental health at all, or this influence is so diminutive that it is exceeded by far by sociodemographic factors. Obviously there is much more fluoride available from other sources nowadays compared to 30 years ago. The results may also have implications for the administration of fluoride tablets and support the recommendations of the DGZMK (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde) from the year 2000, restricting the administration of fluoride tablets to special situations following an individual anamnesis of fluoride uptake.

Click here for paper (fee).

Minnesota Congressional District “Ground Zero” for Terror Group Threat

“It’s just the latest example of how and why Minneapolis—and specifically the congressional district of Muslim Democrat Rep. Keith Ellison (D-MN)—has become ground zero for the threat to the United States from Islamist terror groups such as ISIS and Al-Shabaab.”  here for more

E. coli 0157:H7 Outbreak Linked to Iceberg Lettuce and Agricultural Water

Richard J. Gelting,  Mansoor Baloch,  Max Zarate-Bermudez,  Maha N. Hajmeer,
J. Christopher Yee, Teresa Brown,  Benson J. Yee. A systems analysis of irrigation water quality in an environmental assessment of an E. coli O157:H7 outbreak in the United States linked to iceberg lettuce. Agricultural Water Management. Mar2015, Vol. 150, p111-118.

A foodborne Escherichia coli O157:H7 outbreak in December 2006 included 77 illnesses reported in Iowa and Minnesota. Epidemiologic investigations by health departments in those states and the U.S. Centers for Disease Control and Prevention (CDC) identified shredded iceberg lettuce ( Lactuca sativa L.) as the vehicle of transmission. The U.S. Food and Drug Administration (FDA) and Minnesota and California public health agencies traced the lettuce to several growing regions in California based on information from a lettuce processor in Minnesota. Samples from an environmental investigation initiated by the California Food Emergency Response Team (CalFERT) revealed a genetic match between the outbreak strain and environmental samples from a single farm, leading to an in-depth systems-based analysis of the irrigation water system on that farm. This paper presents findings from that systems-based analysis, which assessed conditions on the farm potentially contributing to contamination of the lettuce. The farm had three sources of irrigation water: groundwater from onsite wells, surface water delivered by a water management agency and effluent from wastewater lagoons on nearby dairy farms. Wastewater effluent was blended with the other sources and used only to irrigate animal feed crops. However, water management on the farm, including control of wastewater blending, appeared to create potential for cross-contamination. Pressure gradients and lack of backflow measures in the irrigation system might have created conditions for cross-contamination of water used to irrigate lettuce. The irrigation network on the farm had evolved over time to meet various needs, without an overall analysis of how that evolution potentially created vulnerabilities to contamination of irrigation water. The type of systems analysis described here is one method for helping to ensure that such vulnerabilities are identified and addressed. A preventive, risk-based management approach, such as the Water Safety Plan process for drinking water, may also be useful in managing irrigation water quality.

‘Use Your Brain to Think For Yourself,’ Reject Career Politicians

“Dr. Ben Carson rolled out his White House bid in front of a fired up capacity crowd at the Detroit Music Hall for the Performing Arts. Carson is competing against an unfriendly news cycle—with a terrorist attack in Texas, race issues in Baltimore, the announcements of two other Republican candidates for president and the release of the bombshell book Clinton Cash this week—but he dazzled as he made his first official steps onto the political stage.” click here

Environmental Sources of Nontuberculous Mycobacteria

Falkinham JO 3rd. Environmental Sources of Nontuberculous Mycobacteria. Clinics in chest medicine. 2015 Mar;36(1):35-41. doi: 10.1016/j.ccm.2014.10.003.

Nontuberculous mycobacteria (NTM) include over 150 species. The source for human infection is the environment. NTM are normal inhabitants of soil and drinking water. NTM grow and persist in many buildings. They are not contaminants of drinking water, but members of the natural drinking water microbial population. Infection occurs because humans share the same habitats. Because the ecology, antibiotic susceptibility, and virulence of individual species differs, identifying NTM isolates to species is important. Treatment requires multiple antibiotics. NTM patients are innately sensitive to NTM infection, resulting in reinfection. Knowledge of the sources of NTM can reduce exposure to environmental NTM.

Elevated Fluoride Levels in Namibia Geothermal Springs

Sracek O, Wanke H., Ndakunda N.N., Mihaljevič M., Buzek F. Geochemistry and fluoride levels of geothermal springs in Namibia. Journal for Geochemical Exploration. Jan2015, Vol. 148, p96-104.

A survey of groundwater from six geothermal springs in Namibia showed high concentrations of dissolved fluoride, with values up to 18.9 mg/l. All values are higher than both the WHO limit and the Namibian guideline. High concentrations of fluoride are linked to Na-HCO 3 or Na-SO 4 -HCO 3 groundwater types, with increasing sulfate and chloride concentrations towards the south of Namibia. Values of δ 2 H and δ 18 O are more negative for the north of the country, and with increasing altitude of springs and distance from precipitation sources towards the southeast from the Indian Ocean. A shift of about 1‰ from the LMWL for Windhoek was observed for δ 18 O samples, which was probably caused by the exchange with reservoir rocks. Values of δ 34 S(SO 4 ) reflect mixing of two principal sulfate sources, i.e., dissolution of gypsum originating from playas and interaction with sulfidic mineralization in tectonic bedrock zones. Values of δ 13 C(DIC) seem to be affected by a variable vegetation cover and mainly by the input of endogenous CO 2 . Estimated reservoir temperatures vary from 60 °C to 126 °C, with a maximum value at the Ganigobes site. The geothermal springs of Namibia in this study do not meet drinking water standards and thus their water can be used only for other purposes e.g. for thermal spas. Treatment would be necessary to decrease dissolved fluorine concentrations for drinking water purposes.

Nano Silver Fluoride Effective for Preventing Caries

Burns J, Hollands K. Nano Silver Fluoride for preventing caries. Evidence-Based Dentistry. 2015 Apr;16(1):8-9. doi: 10.1038/sj.ebd.6401073.

Design: Randomised controlled trial, double blind, in a community setting.

Intervention: School children with active caries in primary teeth and no pulpal exposure, fistula or decay in permanent teeth were chosen. Caries and unsupported enamel were left as found and cotton wool rolls were used for isolation. Two drops of NSF or one drop of water were applied to the tooth with a microbrush for two minutes, once in a 12-month period.

Outcome measure: At one week, five months and 12 months the presence of active caries, as classified using International Caries Detection and Assessment System (ICDAS II) criteria, was measured. If a blunt probe easily penetrated dentine with light force, active caries was recorded and taken to be a failure.

Results: One hundred and thirty primary teeth in 60 children with a mean age of 6.31 (± 0.60) were randomised. Sixty-three teeth were in the NSF group and 67 in the control group. After one week there were no losses, at the five-month follow up eight teeth were lost from the NSF group due to exfoliation or extraction and five from the control group. At twelve months a further five teeth were lost from the NSF group and 13 from the control group.At the one week follow up there was a 19% failure rate in the NSF group compared to 100% in the control group. At the five month recall this was 27.3% NSF compared to 72.6% water and at the final recall there was a 33.3% NSF failure rate and 65.3% control failure rate. The preventative fraction at this point was 50% and the NNT 3.12. All were statistically significant results (p= <0.05).

Conclusions: The annual application of NSF solution was more effective in hardening and arresting dentine caries in primary teeth than the placebo. The effectiveness of NSF was found to be similar to silver diamine fluoride when applied once a year, but did not stain the dental tissue black and had no metallic taste. The application is simple, does not require a clinical setting and is inexpensive. NSF was demonstrated to be effective in arresting caries in children in poor communities, but further studies are required to investigate alternative protocols and for use in tooth sensitivity and root caries.