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The Fluoride Wars: How a Modest Public Health Measure Became America's Longest Running Political Melodrama Hardcover – Apr 20 2009

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"The authors have put an enormous effort into acquiring the data in this book and... it is a very interesting and stimulating read." (Chromatographia, June 2010)

“The authors should be commended for providing all of the facts of the controversy in one place. Their call for both sides to get together to study the health issues with reason and respect is also a worthwhile goal because, as they point out; perhaps then ‘this long-standing and somewhat silly dispute could finally he laid to rest.’” (Chemical and Engineering News, September 2009)

About the Author

R. Allan Freeze is one of North America's leading researchers in the field of environmental water quality, and has acted as the consulting engineer on drinking water quality at a number of sites across North America. He was a member of the University of British Columbia's engineering faculty in Vancouver for twenty years and is the author of over 150 technical articles and the coauthor of several books.

Jay H. Lehr is Senior Scientist with The Heartland Institute and Chief Scientist for EarthWater Global, an international water supply company. A graduate of Princeton University, he developed the first PhD program in hydrology at the University of Arizona and was on the faculty at The Ohio State University. Lehr has authored or coauthored over twenty books, hundreds of journal and magazine articles, and is an internationally renowned expert who speaks worldwide on environmental topics.

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Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
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Most Helpful Customer Reviews on (beta) 12 reviews
14 of 18 people found the following review helpful
Fluoridation: the battles continue Jan. 28 2011
By Brian Martin - Published on
Format: Hardcover
The proposition seems straightforward: should fluoride be put in public water supplies in order to prevent tooth decay? Fluoridation was tested in the 1940s, endorsed by the U.S. Public Health Service in 1950, and implemented in the United States and many other countries in the following decades. But from the beginning, there was vociferous opposition.

The fluoridation debate was in full swing in the 1950s and continues today in much the same form, with the same sorts of claims and counter-claims. Scientifically, the debate has always been one-sided, with an overwhelming majority of dentists and doctors supporting fluoridation but with a significant minority of critics.

The remarkable persistence of the debate has attracted the attention of social analysts. Attempting to take a middle ground is a perilous enterprise, because the partisans on either side are likely to either adopt a contributor as an ally or attack him or her as an enemy.

Scientists R. Allan Freeze and Jay H. Lehr have boldly entered the fluoridation arena with The Fluoride Wars. Their ambitious aim is to provide a balanced social history of the U.S. controversy. They tackle the major issues in the debate, including arguments over benefits of fluoridation and alleged adverse health impacts such as allergies, cancer, and skeletal fluorosis. They give special attention to dental fluorosis, the staining of teeth due to excess fluoride, typically said by proponents to be of only cosmetic significance but seen by opponents as a sign of fluoride toxicity.

A major contribution of the book is its covering of key developments in recent decades, including the antifluoride position of scientists from the U.S. Environmental Protection Agency, the debate among proponents about whether there is too much fluoride in people's diets, the switch by a few proponents to become opponents, the discrediting of some antifluoride claims, and the support for fluoridation by U.S. courts.

Freeze and Lehr also address the social dynamics of the debate, looking at referenda and statewide implementation measures and commenting on explanations of forces driving the proponents and the opponents. All in all, this is the most comprehensive treatment of the debate available in the literature. It draws on key sources, scientific, sociological, and historical.

Several episodes are given detailed treatment, for example, the first trials in which fluoride was added to town water supplies in the 1940s. The historical detail is not a sustained narrative but more like an occasional highlight, with some irrelevant digressions, such as a lengthy account of the Jonestown massacre, included because it had a deep effect on a key legislative promoter of fluoridation in California.

Freeze and Lehr are sufficiently even-handed that their treatment will please neither side in the debate. The book, though, is not a purely dispassionate account because, as well as discussing the scientific and political issues, the authors want to pass judgment and, in doing so, they often shift from nonpartisan social description to summary judgment that can seem to sweep aside disagreement. In particular, they sum up the debate as if it were a matter only of science and of benefits versus costs. The book is more an assessment of arguments than a social history.

The Fluoride Wars is almost entirely about fluoridation in the United States. The authors mention the situation in other countries but do not pursue the implications of fluoridation outcomes elsewhere. They conclude that popular opposition to fluoridation in the United States is due to risk aversion in referenda, but this does not explain the near absence of fluoridation in Europe, where governments make the decisions.

Freeze and Lehr sometimes make sweeping references to proponents or opponents, attributing the views of a few to an entire movement. Their language is frequently flamboyant and occasionally dismissive, for example in referring to scientist opponents as "zealously committed" (p. 362)--and less commonly labeling proponent scientists in a similar way.

The Fluoride Wars concludes with an appeal for the two warring sides to sit down and talk. Although this suggestion almost certainly will be ignored, Freeze and Lehr have set an admirable example of measured analysis and stimulating writing.

Brian Martin
University of Wollongong, Australia
(This review appeared in the Bulletin of the History of Medicine, Vol. 84, 2010, pp. 314-315)
6 of 7 people found the following review helpful
The only objective view of the fluoride controversy I've found April 19 2013
By Merilee D. Karr - Published on
Format: Hardcover Verified Purchase
This book, by a couple of investigative reporters, covers all the claims of both sides. It awards points and demerits to both sides. And it's well written and accessible. Too bad it's hard to find, because it's published by Wiley, an academic and textbook publisher. It should be more widely available. It should be in the pocket and on the kitchen table of everyone who cares about the water they drink.
20 of 30 people found the following review helpful
Makes It A Fair Fight June 11 2009
By Karen Bond - Published on
Format: Hardcover
Definitely an interesting read - a unique mix of social history and popular science. I learned more about fluoride than I thought there was to know! It's filled with lots of anecdotal stories and interesting historical tidbits, vignettes of the principal players on both sides for the fluoride discussion.

I didn't think that the book chose one side or another - and then I read the first reviews. Interestingly, some of the people who gave the book unfavorable reviews are all strong opposers of fluoride who's organizations and arguments are covered in the book.

It's an interesting conflict - covering the controversy of fluoridation (which I didn't realize was a controversy until I read this) - including the almost universal support from the medical-dental establishment, as well as the effective and street-smart strategies of a well-organized opposition.

Fluoride is a double-edged sword. The authors conclude that public water fluoridation, together with the advent of fluoridated toothpaste, are undoubtedly responsible for the precipitous drop in the incidence of childhood dental cavities. But they also join the call for reduced fluoride dosages in public supplies to protect against the threat of negative bone health impacts.

"The Flouride Wars" discusses the heated conflict between the pro-fluoride and anti-fluoride camps. Nothing makes this case more clearly than the first reviews posted on by some of the leaders of the antiflouridation movement in America.

It's definitely a "war" that makes for an interesting read. I don't want a book to make decisions for me, I want it to present both sides honestly. Open-minded readers will find balanced coverage of this long-standing controversy so they can make their own decisions.
A healthy dose of actual science May 8 2015
By Douglas A. Greenberg - Published on
Format: Hardcover
It is clear from the plethora of one-star reviews from denizens of Tin Foil Hat Land that the authors of this book did an effective job of assessing the actual health risks and benefits from fluoridation. The book carefully traces the history of this never ending debate over the alleged conspiracy to "sap and impurify all of our precious bodily fluids" through the addition of small amounts of fluoride to our drinking water. Contrary to the sometimes hysterical criticisms emanating from the one star crowd, the authors actually take the various anti-fluoridarion arguments seriously, subjecting them to careful scrutiny by reviewing the voluminous scientific literature devoted to the question of health risks from fluoridation. In the end, they actually conclude that there is danger, however small, that some people are ingesting larger amounts of fluoride than what is considered safe. Consequently, they recommend that the quantities of fluoride added to drinking water be reduced somewhat.

The book is clearly written and for the most part, entertainingly presented. It does an impressive job of reviewing the history of the politics of fluoridation, as well as the health science associated with the issue. It is by no means a screed against the anti-fluoridation movement. In fact, the authors bend over backwards to give the "anti" arguments their due. But in the end, an assessment of the fluoride controversy has to center on science, not on conspiracy theories or paranoid claims based on just enough knowledge to get it all wrong. Highly recommended.
40 of 70 people found the following review helpful
Fluoride Wars- polemics not science April 14 2009
By Paul Connett - Published on
Format: Hardcover
Fluoride Wars- polemics not science

Despite lofty claims of objectivity, and being published by a major Science publisher (Wiley), the book "Fluoride Wars" by Freeze and Lehr is not a scholarly work but rather a slanted polemical analysis which gives final victory - with a few caveats about some of their bullying tactics - to the status quo.

More journalism and pseudo history than science. Why on earth spend four pages discussing Jonestown? Freeze and Lehr provide their thesis in the subtitle: "How a modest public health measure became America's longest running political melodrama." However, you can only describe water fluoridation as a modest measure if you conveniently ignore - as these authors do - the fact that the level of fluoride added to water (i.e. 1 milligram per liter or 1 part per million or 1 ppm) which may seem small to some, is actually 250 times the level found in mothers milk (0.004 ppm). This means that a bottle fed baby in a fluoridated community gets 250 times more fluoride than nature intended.

To support their thesis of a "political melodrama" they focus their attention more on the extreme wings of the debate (Michael Easley, Stephen Barrett, Darlene Sherrell) than on the calmer scientific middle. They spend more time discussing and debunking conspiracy theories then on a careful balanced analysis of the scientific details.

The authors show little first hand knowledge of the primary literature and derive most of their conclusions from governmental reviews and review articles, sprinkled with self-serving commentary from the American Dental Association. Even this analysis is dated. Incredibly, while on page 250 they make it clear that they are aware of the massive 507-page groundbreaking review by the National Research Council (NRC) "Fluoride in Drinking Water: A Review of EPA Standards" published in 2006, apart from acknowledging that the authors called for a lowering of the EPA's drinking water standard, Freeze and Lehr do not provide any commentary on the scientific findings of this important work. This despite the fact that this landmark NRC review cited 1100 references to the primary literature, and addressed two of the key questions Freeze and Leher raise: "What is the status of current medical research into the impact of fluoride on human health? What conclusions can be drawn on the basis of toxiciological and epidemiological evidence currently available with respect to each potential impact or disease?"( p.31).

If objectivity was their aim it is surprising that Freeze and Lehr completely ignore the NRC analysis, while spending considerable time on earlier reviews. An "inconvenient review" perhaps if one's ultimate aim is to support the medical establishment's continued promotion of this unacceptable medical practice. Unacceptable, because once fluoride is put in the water, you can neither control the dose nor who gets it (young or old, sick or healthy) as well as depriving the individual's right to informed consent to what medication he or she takes. Throw in the fact that no one is monitoring side effects and we have a really horrible medical practice.

Had Freeze and Lehr studied the NRC (2006) review they would have realized that their own review of health effects was dated and limited. For example take fluoride's potential to impact the brain. Instead of the few studies that they cite, they would have discovered that there have been many more studies published since the ones they addressed. In fact, if they had availed themselves of the health data base on the web site of the Fluoride Action Network they would have discovered that there are now over 50 animal studies which indicate that fluoride damages the brain and no less than 23 studies (from four different continents) which show that high fluoride exposure is associated with lowered IQ in children. Maybe nature had reasons for keeping fluoride so low in mothers milk.

While the book reveals some fascinating bits of history about some of the protagonists in this debate and acknowledges some of the shabby treatment they have received at the hands of pro-fluoridation sources, the book is not very helpful in drawing serious conclusions about the science of the debate over either effectiveness or the safety of this measure.

As a protagonist myself, I do not feel that my 13 years of painstaking review of this issue, first as a professor of chemistry, and then as executive director of the Fluoride Action Network, was served very well. While I was amused that they mentioned my classical music program on my local public radio station, I would have much preferred it if they had attempted a blow by blow critique of my "50 Reasons to Oppose Fluoridation." If readers were to avail themselves of this documented argumentation they would get a better feel of just how much of the fluoridation debate was side-stepped by these authors.

Paul Connett, PhD,
Professor Emeritus of Environmental Chemistry,
St. Lawrence University, Canton, NY
Executive Director,
Fluoride Action Network,