Ending the Betrayal of Trust

August 8th, 2010 jamesrobertdeal No comments

Bulletin: Ending the Betrayal of Trust

By Paul Connett, PHD

August 8, 2010

Even though the combined forces of the CDC (and other agencies of the mighty US Department of Health and Human Services- DHHS) and ADA have enormous political power and huge financial resources, as far as fluoridation promotion is concerned they are lumbering giants waiting to be toppled by some shrewd tactics from citizens. Why do I say that?

a) Because there is no scientific substance to their repeated mantra that fluoridation is “safe and effective.”

b) They have only been able to get away with this lack of scientific support for their assertions because they have been able to keep doctors, dentists, scientists, the media and the general public away from the literature. They can’t do that any more because the science is now readily available via the internet.

c) Moreover, many of the citizens’ concerns about fluoride’s dangers has now been validated by the National Research Council in their landmark 507-page report published in 2006.

d) In my opinion, no professional can read the NRC report and can honestly conclude that there is an adequate margin of safety between the doses now known to cause harm and the doses that some people will receive drinking uncontrolled quantities of fluoridated water along with fluoride from other sources (especially vulnerable subsections of the public).

e) Even the ADA and the CDC now admit that bottle fed babies should not be given fluoridated water (even though they are not taking vigorous steps to get this message to parents). If it is not safe for everyone then the practice should cease immediately.

f) The evidence of harm is too visible to be ignored. 32% of American children now have dental fluorosis. It is reckless to assume that if fluoride can damage the growing tooth cells in a baby’s body that it will not impact any other tissue. With risks clearly involved the notion that governments should force this on people without their informed consent is even more ridiculous.

g) More and more professionals are recognizing these facts and speaking out. These include the 11 unions that represent professionals at the US EPA; over 3000 professionals calling for an end to fluoridation and the 15 of these who have articulated their position in a widely-watched videotape, “Professional Perspectives on Water Fluoridation.”

h) For those who have missed all these sources of information that undermine the promoters’ case, our book coming out in early October should put the final scientific nails into their coffin.

i) Hitherto, the two chains of command operated by the CDC and the ADA have been able to get doctors, dentists and public health officials to mouth their unscientific assertions with confidence.  However, there are signs that that confidence is evaporating as more and more dentists are waking up to the fact that they have been lied to do by the ADA both on the “safety” of mercury amalgams and the safety and effectiveness of water fluoridation.

j) So how can citizens further exploit these weaknesses and topple the huge web of deception that water fluoridation has become? First, it helps to know their game plan. We have seen this played out again and again in towns across the country. Whenever, fluoridation is proposed or threatened, the ADA arranges through its state dental association and thence to the local dental society to besiege council chambers with their white-coated army of dentists. This is coupled with a few choreographed letters to local papers signed by local dentists and doctors (but usually written by PR firms). The Florida Dental Association has recently made this strategy clearly visible.

k) The promoters’ strategy only has a chance of working if they can get local dentists and doctors playing along and as we have indicated above more and more are smelling a rat. Not being on top of the literature cuts both ways: on the one hand dentists and doctors can be easily misled by the ADA and often become easy puppets. In the past their confident assurances have been believed and they have won the day.  On the other hand, today, now that more and more citizens are on top of that literature, dentists and doctors are finding that they have been set up for some real professional embarrassment when the mistakes and half-truths are pointed out – in public.

l) Some people find this all very hard to believe. Why would the CDC and the ADA continue to push this practice if they knew a) it wasn’t working and b) it might be causing harm? What could possibly be more important than the public’s health (let alone the public’s purse). The answer lies in two words: credibility and liability.

The CDC fears that if they have been found to be wrong on fluoridation that they will suffer a huge credibility hit. Public health requires the public’s trust. If the public loses its trust in the CDC’s claims on fluoridation, what about its trust in vaccinations and other public health measures?

For the ADA it is probably the fear of both losing professional credibility (think of those 120,000 annual dues from their members) and liability that drives them forward. The ADA has its name on every fluoridated dental product sold in the US. These sales are worth millions. In addition, the legal costs of defending against class action lawsuits would bankrupt them. They simply cannot admit to any harm. Thus they have to deny the scientific significance or relevance of every health study that finds harm, including the whole of the  NRC (2006) report, which they did on the very day it was published (March 22, 2006).

m) Assuming that the ADA can still find dentists to come to public meetings and mouth the party line, or the CDC can get public health officials to do likewise, how can citizens defeat this 60-year strategy today? The answers are very simple:

1) First of all citizens must make it clear that ethics must come before science in this matter. No government – no matter how well-meaning– has the right to force any citizen to take a medicine. The right to informed consent to medicine is enshrined in modern medicine and is well articulated by the AMA. Citizens should wear this sign around their necks to public meetings on this issue: “I do NOT give my CONSENT!”

2) Citizens and councilors have to make it very clear that dentists have no professional expertise to make statements on any tissue in the body other than teeth. The dental lobby has controlled this debate for far too long. Dentists should be pulled up short the fist time the word “safe” comes out of their mouths. They have no expertise to make that statement. “Sir, I trust your judgment when it comes to my teeth, but not when it comes to my bones or my children’s brains. What qualifications allow you to speak on other tissues in my body and the harm that fluoride may cause them.”

3) Should they claim otherwise, then further questions should elicit what primary scientific literature they have read that supports their claims of safety and effectiveness. When it becomes clear that they cannot cite many – or any – primary studies to support their claims, but rather resort to CDC statements or ADA and other agency endorsements or self-serving government reviews, then this must be called what this represents: hearsay evidence.

Citizens’ questioning might go along these lines:

Question 1: “ Sir, (or madam) can you cite a single peer-reviewed published study that has used a randomized clinical trial to establish ingested fluoride’s ability to reduce tooth decay?”

They can’t do this – they simply don’t exist

Question 2: “Sir, what primary scientific studies have convinced you that fluoridation poses no dangers to human health other than dental fluorosis?”

 

The chances are high that they won’t be able to do this and instead cite endorsements or reviews from government-sponsored bodies like the NHMRC (2007) in Australia. Ask these follow-up questions:

Question 3:“Sir, in this report you have cited, can you tell me what primary studies it contains that you feel best establishes the safety of fluoridation? Have you read these studies?”

If they cannot answer these questions then the follow up question could be:

Question 4: “Sir, is it not true that you haven’t read the primary literature yourself and that what you are telling us is based on what you have been told? Isn’t that tantamount to hearsay evidence?”

4) If the brave dentist or doctor continues to insist he has qualifications to speak on these matters, then ask him or her whether they have read the NRC (2006) report.

 If they answer no, they don’t look as if they are on top of the issue. If they answer yes then ask them “Is it in your professional judgment that there is an adequate margin of safety between the does that cause harm as documented in this report sufficient to protect everyone in society – including vulnerable subsets of the population -drinking uncontrolled amounts of fluoridated water and getting fluoride from other sources?” Some might brazen this out and say yes, but I don’t think they will be very convincing, especially if you ask them what kind of margin of safety they think would be needed for this purpose. Normally, a margin of safety of 10 is needed between the lowest level that cause harm and the highest dose that people will receive. This margin of safety is needed to take into account the full range of sensitivity that any human population will have to a toxic substance. Such a margin of safety if applied would eliminate fluoridation based on several adverse health effects identified in the NRC report (arthritic symptoms, bone fractures, moderate and severe dental fluorosis, lowered IQ and lowered thyroid function).

5) Personally, I have no joy in the prospect of embarrassing professional people in public on this matter and I hope that it doesn’t come to that. Hopefully, we can warn them ahead of time that if they go along with the CDC/ADA game plan then they are going to look foolish in the public’s eyes when their many mistakes and half truths are pointed out. If they ignore these warnings and go ahead and risk this professional embarrassment, then so be it. Their embarrassment is a small price to pay in order to end the pain and worry that this reckless and unnecessary practice is causing.

I wish I had known all this 14 years ago when the phalanx of local dentists and doctors used their professional standing in our community to assure people at a public meeting that fluoridation was “safe and effective.”  It was only after the meeting was over that I discovered that one of the doctors present was not on top of the literature and even refused to take three scientific articles I asked him to read after the meeting. He said, “I don’t have time to read those.” When I said that that was not very responsible, he said “I don’t have time to read up on every issue that crosses my desk.” To which I replied, ‘I quite understand that, but you shouldn’t let people believe that you have studied this issue and that fluoridation in your professional judgment is safe.”

In my view the promotion of this practice by the CDC and the ADA is a betrayal of trust. First, it betrays the trust of the busy professional who cannot keep up with the Bulletin: Ending the literature. Second, it is a betrayal of the public trust when these same professionals tell the public that fluoridation is safe, based only what they have been told by others and not their own review or research of the literature.

This betrayal must come to an end and we are going to need a well-informed army of citizens to do it.  We start by eliminating the testimony of those who haven’t read the literature, and then we move on to the middle men, those like the dental directors of state health departments, whose job it is to promote fluoridation. Unlike your local doctors and dentists this goes beyond mere embarrassment. Because they are paid by the taxpayer they are obliged to demonstrate due diligence. They cannot do this. We simply have to demonstrate that.

Paul Connett

Categories: Uncategorized Tags: ,

JRD Presentation at FAN Conference

July 30th, 2010 jamesrobertdeal No comments

7-29-10  

Friends,  

I have posted the comments I made at the FAN conference – http://fluoride-class-action.com/fan-conference/jrdeal-presentation. Give me your feedback on these proposals. You will not hurt my feelings if you disagree with me.  

If you know any lawyers who are interested in doing litigation or working pro bono in the pre-litigation, threatening stage, forward this e-mail to them, please. My role is to recruit and assist The New Fluorine Lawyers.  

If any of you have notes about the FAN conference and what we should be doing to move this along, please reply to all.  

***  

I would invite you to join my new Yahoo discussion group so we can have relatively confidential conversations about fluoridation with people we know. The group web site is at http://groups.yahoo.com/group/Fluoride-Class-Action/.   The difference with this list serve is that it will be moderated as to membership and content. Only people we know and trust will be accepted for membership. Messages will be reviewed to eliminate spam and bothersome messages.  

Bill and I and maybe Aliss Terpstra can serve as moderators as to who can join.    

Other fluoride list sharing groups are open to anybody, and that’s okay. But I would like to know that the pro-fluoride attorneys are not reading our conversations.  

De-fluoridation activists in the US, Canada, Australia, NZ, Great Britain and other countries are invited to join.  

To join send a message to: Fluoride-Class-Action-subscribe@yahoogroups.com   You will be asked to identify yourself. 

My motto: They have all the money, but we have all the good ideas. We will win. The question is how long it will take. And that depends on how organized we get and – because litigation will be necessary – how much money we raise.  

If you attended the FAN conference please post ideas about what we should be doing – both in the pre-litigation stage and in the litigation stage.   I will try to post more notes about the ideas we came up with at the FAN conference.

Ellen Connett said she is going to put the three presentations up on the www.FluorideAlert.org website – if the recording quality turns out good.    

Sincerely,

James Robert Deal

Mercola & Connett on Fluoridation

July 10th, 2010 jamesrobertdeal No comments

Dr. Joseph Mercola and Dr Paul Connett discuss the need to end water fluoridation without further delay.

See their video entitled “Warning:  This Daily Habit is Damaging Your Bones, Brain, Kidneys, and Thyroid“.

This is the link: http://articles.mercola.com/sites/articles/archive/2010/07/03/paul-connett-interview.aspx

Read the transcript here.

Categories: Video Tags: ,

Nuclear Power is Not Green

July 6th, 2010 jamesrobertdeal 6 comments

Nuclear Energy is Not Green
By James Robert Deal

The Seattle Times has published another one-sided propaganda piece in praise of nuclear power, written by a career nuclear supporter. (See “Nuclear energy, version 3.0 – time to revisit this low-carbon energy source,” Seattle Times, July 4, 2010.

Nuclear power is not “low-carbon.” Although nuclear plants do not emit carbon dioxide, the mining and enriching of nuclear fuel is highly energy intensive. When this is factored in, nuclear power has a carbon equivalent approaching that of natural gas. Further, around five percent of energy production from a nuclear plant is expended containing and cooling nuclear reactions.

There is no mention in the pro-nuclear article of how filthy the mining of uranium is. Uranium mining in Canada has left behind 200 million tons of radioactive tailings, fine as flour, which blow in the wind and flow downstream for hundreds of miles. The article says that nuclear fuel is cheap, but that is true only if you ignore the huge environmental cost of mining it. Radioactive and heavy metals should be left in the ground as much as possible.

No state wants nuclear waste. Nevada opposition to Yucca Mountain has resulted in its rejection. Every site seems to be geologically unstable, which is not surprising on a planet where continents are slowly but constantly moving. So waste is being stored on site, at plants where it is produced. No permanent technology for storage of spent fuel has been developed.

The presumption underlying the pro-nuclear article is that without nuclear power it will be impossible to meet our energy needs. However, Dr. Arjun Makhijani, Ph.D., consultant to corporations and governments, says

Wind energy resources in 12 Midwestern and Rocky Mountain states equal about 2.5 times the entire electricity production of the United States… Solar energy resources on just one percent of the area of the United States are about three times as large as wind energy.”

See www.ProCon.org, which presents both sides of the nuclear power debate.

A study commissioned by the state of California found that in terms of both capital construction cost and ongoing cost per kwh, wind beats nuclear hands down, while solar is competitive. Google for “Levelized Cost Of Energy Analysis – Version 2.0.”

A new reactor typically costs $5 to $7 billion, and cost overruns are common. It has taken from eight to 24 years to complete nuclear power plants in the US. The same billions spent to build solar arrays, windmills, geothermal heat pumps, microbial fermenters, tidal and wave farms, and many other alternative technologies can yield results more quickly and supply all the power we need.

Proliferation is a concern. A country with nuclear power plants is a step away from nuclear weapons. If the US had not encouraged the Shah to build nuclear power plants in the 1950s, perhaps Iran would not now be building nuclear weapons. If the United States builds hundreds of nuclear plants, other countries, including unstable countries, will build thousands. Promoting nuclear energy as a worldwide solution to energy needs is like giving children loaded guns to play with.

Security is a concern: Each nuclear power plant is a terrorist target. If the US builds hundreds of nuclear plants, other countries will build thousands. With a few pounds of plutonium a sophisticated terrorist can make a nuclear bomb; an unsophisticated terrorist can make a dirty bomb. Perfect security is impossible to achieve with such toxic material.

Nuclear energy proponents claim that nuclear fuel is cheap. To the contrary, each nuclear power plant is bankrupt from the day it is built. The energy produced over its 40-to-60-year life span can never cover the cost of storing and guarding its nuclear waste for thousands of centuries.

Nuclear power is so risky that lenders will not lend to utility companies for construction of nuclear plants without federal loan guarantees. Nor are insurers willing to insure against liability, so under the Price-Anderson Nuclear Industries Indemnity Act, the US government covers the majority of any loss. Like the coal and oil industries, the nuclear industry receives large tax credits. Like the others it is a “protected polluter.”

Time continues indefinitely into the future. Ice covered much of the northern hemisphere 10,000 years ago, including the Hanford Reach, and it will return someday. Glaciers will crush nuclear plants and waste dumps and spread radioactivity. Wars will come. Countries will collapse. Reactors will be neglected or sabotaged and burn like Chernobyl. Suitcase nuclear bombs will be detonated. Our descendants will curse us if we continue down the nuclear road.

End

Categories: Nuclear Power Tags:

IAOMT Amici wanted to reply to fluoridation supporters

April 3rd, 2010 jamesrobertdeal 1 comment

There were nine amici curiae (Latin plural for “friends of the court”) in the Port Angeles case who filed a 30-page brief. I served as their attorney. It’s primary aim was to force the Court to look at the science on the subject of fluoridation. The links:

The IAOMT Amicus Brief

IAOMT Brief Appendix A, Interests of the Nine Amici Curiae

IAOMT Amicus Brief, Appendix B, Bruce Spittle, M.D., Fluoride Fatigue

IAOMT Amicus Brief, Appendix C, McQuillan on Initiatives

IAOMT Amicus Brief, Appendix D

IAOMT Amicus Brief, Appendix E, Stan Hazen Deposition

The City of Port Angeles and the Dental Foundation filed their Motion to Strike the IAOMT Amicus Brief.

The IAOMT Amici filed their Response of IAOMT Amici to Port Angeles’ Motion to Strike IAOMT Brief. The Supreme Court accepted both the brief and the defense of the brief.

Other fluoridation supporters filed their Fluoride Supporters’ Answer to IAOMT Amicus Brief. Attached to it was an article by Howard F. Pollick, Water Fluoridation and the Environment, Current Perspectives in the US. These documents were riddled with legal and scientific errors.

The IAOMT Amici cannot reply to the Fluoride Supporters’ Answer without permission from the Court. So the IAOMT Amici are asking to be allowed to reply to that answer.

Click here to read the letter of the IAOMT Amici to the Supreme Court.

Unfortunately, the Supreme Court said it had heard enough and declined our offer to reply to the fluoride supporters’ brief.

Categories: Uncategorized Tags:

Fluoride in the New York Times

March 2nd, 2010 jamesrobertdeal No comments

3-2-10

Dear Fluoride Debunkers,

This is in Today’s NY Times. It’s about Blytheville Arkansas’s water. That’s just down the road from Promised Land, where where I fell to earth.

http://projects.nytimes.com/toxic-waters/contaminants/ar/mississippi/ar0000365-blytheville-waterworks

Go here to the Environmental Working Group and sign up for their e-mails. They apparently broke this story.

Pretty amazing stuff. The truth is starting to boil over.

I talked with Matt Mosley, one of the administrators at the Blytheville Water Works. Matt says that they go through two 55-gallon drums of fluorosilicic acide each month and that after Hurricane Katrina the fluoride started coming from China. Blytheville has been fluoridated since the late 1960s, so I drank that water until I left there in 1965. Water there comes out of an aquifer that is 1,800 feet deep and which stretches from the Bootheel of Missouri down to Memphis. Whether the massive quantities of pesticides and other chemicals sprayed on crops can penetrate that deep is something I have no information on.

Let’s all make a special push to bring this issue into people’s consciousness.

If you really want to do something to fight fluoride, mail a Freedom of Information request like this one and send to your city or water works:

http://dealmortgage.net/fluoride-class-action/arkansas-fluoride-freedom-of-information-request.htm

Organize!  Send these notices out. Send copies to the mayors and city council people. Send copies to the newspaper. Find an attorney who has a conscience and ask him to sign them. Hold press conferences. Find a respected person to serve as spokesman.

Follow up as soon as they respond and send out a Notice of Potential Liability like this one:

http://dealmortgage.net/fluoride-class-action/notice-to-arkansas-of-liability-12-16-8.htm

Hold another press conference.

When your water district fails to send you an assay of raw scrubber liquor fresh from some Fluorida or Chinese phosphate fertilizer factory, send him a letter like this:

http://dealmortgage.net/fluoride-class-action/reply-to-everetts-refusal-to-do-full-assay-of-raw-fluoride-scrubber-liquor-6-29-9.pdf

If we all push simultaneously, we can accomplish something. Don’t leave it up to others. Organize your group. I would love to fly in and do an organizational seminar and rally. I would help you write up all these documents so you can get started. If you can recruit a local lawyer, I will work with him.

Conive. Plot. Conspire. “Kick at the night until it bleeds daylight.”

DO SOMETHING!

Sincerely,

James Robert Deal , Attorney, Loan Officer
James@JamesRobertDeal.com

PO Box 2276 Lynnwood WA 98036

Telephone: 425-771-1110
Fax: 425-776-8081

www.JamesRobertDeal.com

www.DealMortgage.net

www.Mortgage-Modification-Attorney.com

www.Fluoride-Class-Action.com

www.WhatToServeAGoddess.com

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Categories: Arkansas, Fluoride Articles, Lead Tags:

Saurheber: Poisoning from Fluoridated Public Water

March 1st, 2010 jamesrobertdeal 1 comment

Chemical Analysis of Poisoning from Fluoridated Public Water
Richard D. Sauerheber, Ph.D.

Abstract. The mechanism by which fluoride from unnatural sources exerts adverse effects in man and animals is examined. Low level artificial fluoridation of municipal water can cause well known alterations in teeth and bone structure with incorporation of fluoride into a wide array of tissues and increased hip fracture tendency, depending on years of exposure and water hardness. High accidental levels cause acute lethal poisoning and are responsible for fluoride listings on poisons registries and for their major industrial use as rodenticides, insecticides or pediculicides. Solubility calculations indicate that blood fluoride concentrations required to decrease calcium below normal physiological levels compare to those present in the tissues of poisoned victims and to those causing decreased beat rates in isolated heart cells in culture. The effects of calcium ion and pH over broad ranges on the free fluoride ion concentration were determined. Acute lethal poisoning with heart attack, and also many of the chronic ‘low’ level effects of fluoride, are mediated by calcium binding by fluoride ion. At a pH typical of gastric juice, approximately 50% of fluoride is protonated as hydrofluoric acid HF, with 50% remaining the free fluoride ion. The significance of these observations is discussed in terms of potential hazards, both short and long term, associated with consumption of artificially fluoridated waters of varying calcium content.

Read the full article here:
http://fluoride-class-action.com/wp-content/uploads/sauerheber-chemical-analysis-of-poisoning-from-fluoridated-public-water.pdf

2-28-10 Update

February 28th, 2010 jamesrobertdeal No comments
2-28-10
 
Dear Fluoridation Debunkers:
 
I am working on a reply to the brief filed by the Washington Dental Service Foundation, Washington State Dental Association and the Fluoride Research Committee in the Port Angeles case, together referred to as the “Fluoride Supporters.”
 
Read the brief here.

It is riddled with errors, and I need to point them out.

Please help me pick it apart.

Also we need to pick apart the Howard F. Pollick article cited in the brief:

http://fluoride-class-action.com/wp-content/uploads/water-fluoridation-and-the-environment-current-perspective-in-the-us-howard-f-pollick.pdf

Try to send me your comments within the next week. I will then put them together in a reply and make a motion for the court to allow it.

***

I am looking for the document addressed to dentists which says that it is not necessary for them to understand the science of fluoridation, that it is too complex and they just need to believe in it.

***

Dr. Sauerheber’s comments:

Date: Mon, 22 Feb 2010 12:02:19 -0800

See the graph referred to on page 69 of Dr. Spittle’s book:

Here’s what I could do for you for the time being today. Thanks for your work.  

                                   Feb. 21, 2010

Comments for the Port Angeles case on water fluoridation, 82225-5, Supreme Court, Washington State

Submitted from:

Dr. Richard D. Sauerheber, Ph.D. Chemistry, University of CA, San Diego, La Jolla, CA 92037

Currently Palomar College, San Marcos, CA 92069

  First, on page 37 of the Pollick article, a sweeping bold claim is made that is false, that “there is no credible evidence that the [fluoride] chemicals are unsafe.”  This bias held by the author is easily refuted below with just one simple example.  Second, the court briefing points contained additional falsehoods, particularly regarding the claim that LD50’s have no applicability to water fluoridation and that fluoride chemicals ingested and assimilated into the blood are not being used as drugs.

   On page 94 of the National Research Council Report on Fluoride in Drinking Water, 2006, note that in only 24 months consuming water with fluoride (Cumulative data from natural and artificially fluoridated water at these levels!!) at 1-4 ppm that fluoride incorporates irreversibly into bone at thousands of times that in the water. This is consistent with the fact that only 50% of assimilated fluoride is ever excreted. The NRC found that once fluoride incorporates into bone it is permanent. Bone fluoride cannot be removed or lowered even after transfer for 25 years to fresh water consumption. The fact that the accumulation is a linear dose response that is not saturable, even to levels above 12,000 ppm in bone (p. 95) and is not reversible demonstrates without doubt that this effect is pathologic, not physiologic. All mineral nutrients required to support physiologic processes always exhibit effects in dose response studies that are fully saturable and are reversible and cuvilinear.

   At 1 ppm water fluoride, on average where blood levels are 0.21 ppm (p. 70) bone levels are several thousand ppm typically, with scatter in the data determined mainly by water hardness and calcium ion content.  After lifetime consumption by reasonable extrapolation from lifetime consumption data for 3-4 ppm water (10,000- 12,000 ppm in bone which often causes hospitalization for severe bone pain) 1 ppm water leads to about 4-5,000 ppm in bone.  The NRC concluded that levels above 3,000 ppm definitely weakens bone to a significant, readily detectable degree.  Yes, the error of measurement is larger than the smaller effect noted at 1 ppm for 2 years (2,000 ppm in bone), but any claim bone at this level is magically not weakened at all is erroneous. Indeed, this is why toxicology data at high accumulation levels are needed to help determine any significance of data at much lower incorporation levels (that of course continue to accumulate toward significant levels with continued consumption).  We have an epidemic of hip fractures in the elderly that are fatal during convelescence while waiting for bone to heal. Fluorotic bone is weakened and metabolically abnormal and I personally blame artificial fluorides as a chief cause of this rise in slow healing of fractures experienced in recent decades.

   The idea that the NRC report does not apply to ‘water fluoridation’ is an incredible sweeping claim, that in fact completely contradicts the claim also made, that fluosilicic acid after dilution is argued by fluoride promoters to mimic natural water fluoride. Which is it? This self-contradiction is simply bizarre, where fluosilicic acid after dilution duplicates natural fluoride (from calcium fluoride, not an acute toxic compound with an LD50 of 3,500 ppm), and yet since some of the data in the NRC Report are from natural fluoride water, the entire data set (which includes also unnatural fluoridated water AS WELL) “does not apply”, because it is natural and fluoridation is suddenly now “not natural”. This is self-serving at best and is a blind hope that promoting the pro viewpoint is somehow just, which is merely promoting a vested interest, in my humble opinion.

    The idea that LD50’s do not apply to ‘water fluoridation’ was disproved in 1994 in Hooper Bay, Alaska where 302 people in the half of the village where an overfeed occurred were sent to the clinic with severe chest pain and acute stomach pain. One victim did not survive a heart attack. In my review of the work it was firmly established that the fluoride blood level in the lethal victim had reached that which precipitates calcium from the blood to block the heart beat (see attached document submitted for publication).  Gessner in his review (“Acute Fluoride Poisoning form a Public Water System”, New England Journal of Medicine, vol. 330, 1994) was unable to decide whether the artificial fluoride killed and poisoned by decreasing blood calcium or rather another mechanism.  Of course everyone desires that such overfeeds will never happen again but sadly this is not the case (www.fluoridealert.org for an accumulating list of overfeeds in the U.S.). If overfeeds did not exist, then we could switch to using MCL’s rather than LD50’s to describe only chronic toxicity. In such an ideal world where no one made dosing errors for this hazardous waste, then I might have agreed, that we then have the luxury to switch to using MCL’s as our concern for only chronic low level toxicity at that point, but I deal with the actual world, not the dream ideal one.

  The notion that artificial fluosilicic acid is injected to treat cavities and thus is “not a drug” has no pharmacological basis. First, please examine for example ‘the Bible of Pharmacology’, Goodman and Gilman’s “Pharmacologic Basis of Therapeutics” which contains a fluoridation section because indeed injecting any artificial material, no matter if found in a natural environment in some waters or not, for the purpose of elevating fluoride levels in human blood to affect any tissue is the definition of a drug. Second, the FDA has never approved of artificial fluoride ingestion and indeed also for the same reasons require warning labels on toothpastes to not swallow, or to use at all in any person under six. Third, FDA spokesmen routinely refer to water fluoridation as an “uncontrolled use of a drug” where dosage cannot be regulated because individuals require vastly different water consumption amounts depending on a plethora of normal physiologic differences and various abnormal health conditions, such as diabetes mellitus where consumption rates are often twice normal (NRC, 2006). Finally, please understand that there is no mechanism by which one can direct swallowed fluoride, that enters the bloodsream, to only attach to teeth rather than to incorporate into systemic tissues. All swallowed fluoride seeks calcium wherever it is enriched because fluoride is a calcium chelator. Calcium is the antidote to fluoride poisoning and minimizes assimilation when fluoride is injected into hard water. Indeed, artifcial fluorides when intentionally ingested are drugs and require listings of exact dosage instructions and known side effects of overconsumption, accidental or otherwise. If natural calicum fluoride had been used to ‘fluoridate’ drug Hooper Bay water supplies, then no one would have been killed or severely poisoned (LD50 = 3,500 ppm for natural calcium fluoride) because calcium fluoride already has its desired ingredient along with it and because only artificial fluorides without calcium are soluble to massive amounts in soft, calcium deficient water. The other well documented case of poisoning intermediate between ‘acute’ and ‘chronic’ are the Pagosa Springs horses raised by out of state ranchers on city fluoridated soft water. the horses were slowly slaughtered over a 9 year period before toxicologists arrived to determine it was the massive fluorosis that killed them. This could not have happened in hard water, or if calcium fluoride were used as a drug instead of fluosilicic acid in the soft water the city has (Krook and Justus, “Horses Poisoned from a Fluoridated Water Supply”, Fluoride, Jan, 2006. The distinction between acute LD50 and chronic MCL is irrelevant since the animals were killed, which do we call it when it happened to require 9 years to achieve but the effecte was terminal? Much more important is the fact that fluoride at 1 ppm in the ocean, with thousands of ppm calcium, is harmless to salmon, that are extremely sensitive and are narcotized in fresh calcium-free water by only 0.3 ppm artificial fluoride.  

  Please consult www.lulu.com for the free pdf download entitled “Toxicity of Water Fluoridated Artificially” for the petition to the FDA to ban this practice for our country. 

  This is only a partial list of problems with the testimony submitted in this Port Angeles, WA fluoridation case. I also have examined the detailed studies of Phyllis Mullenix and found they are exceptional and are unbiased, performed with computer controlled movie cameras that determined animals at blood levels of fluoride comparable to humans in 1 ppm fluoridated cities exhibit alterations in mental behavior with confusion under stress in hundreds of studies that correlate with incorporation of fluoride into the brain medulla oblongata. There is zero doubt that assimilated fluoride crosses the blood brain barrier. The issue is how long can one incorporate it with only minor unrecognized effects (i.e. in extracellular brian components) before eventually exhibiting adverse effects that are demonstrably significant in humans. The numerous foreign journal artricles (about 18 in number) recently translated into English that demonstrate decreased IQ in children raised on only 2-3 ppm water are now available at www.fluoridealert.org.

Sincerely,
Richard Sauerheber, Ph.D. Chemistry

Attachment naturefluoridearticle.doc: “Chemical Analysis of Poisoning from Fluoridated Public Water”—contains data indicating the pH dependence of formation of hydrofluoric acid HF from artificial fluoride and data indicating the activity vs. the concentration of the fluoride ion in water as a function of calcium concentration as well as a detailed chemical analysis of the mechanism by which blood fluoride from an overfeed disaster killed and poisoned in Alaska. This article has thus far received comments by the editors of Nature who felt it of insufficient priority to publish at this time. I plan to shorten the manauscript and submit it to a general toxicology journal. 

James Deal,

   I thought you also would like to have the attached graph that indicates the uselessness of ‘water fluoridation’ in its stated objective. The data are from 39 Washington State Counties, according to percentage of people in each county that has fluoridated water (blue curve). Also on the graph (red curve) are the percentage of decayed or filled tooth surfaces in 3rd grade residents of those Counties. Decay remains quite comparable in all Counties in spite of the absence or presence of wide variations in water fluoridation %. This is in agreement with the findings of Dr. Osmundson in Oregon in his all-50-states study in the U.S., also pubnlished in this book on page 68.
 
  The graph was from a book rcently donated to me from a friend. The reference is:
 
Bruce Spittle, Fluoride Fatigue (Revised 3rd printing), Paua Press, Dunedin, New Zealand, 2008,  p.69. 

http://www.pauapress.com/fluoride/files/1418.pdf
 
  Dr. Spittel is the recipient of the John Malcolm Memorial Prize in Physiology and Biochemistry. The text mainly summarizes much recent data on fluoride poisoning in man and animals from several biochemical research scientists.

Read Richard Sauheber’s article at:
http://fluoride-class-action.com/wp-content/uploads/sauerheber-chemical-analysis-of-poisoning-from-fluoridated-public-water.pdf

Categories: Uncategorized Tags:

Dr. Bruce Spittle on Fluoride Fatigue

February 28th, 2010 jamesrobertdeal No comments

Read Dr. Bruce Spittle’s book here.

Double-blind clinical studies and numerous case studies demonstrate that from one to five percent of the population, are hypersensitive to fluoride to varying degrees, and these people can experience incapacitating symptoms that can drive them to move away from cities with fluoridated water.

Dr. Bruce Spittle, M.D., Fluoride Poisoning: Is fluoride in your drinking water—and from other sources—making you sick? 2008, ISBN 978-0-473-12991-0, which can be downloaded from http://www.pauapress.com/fluoride/files/1418.pdf.

The Washington Supreme Court stated in 1954 that if city water is fluoridated, it will be necessary for residents “to use it for domestic purposes including drinking, because there is no other practical source of supply.” Kaul v Chehalis, 45 Wn.2d 616, 277 P.2d 352 (1954) at 618. Some people cannot afford a distiller or a whole house filter. Some are not strong enough to haul water jugs home. Some do not own a vehicle. Some cannot afford to buy water.

http://fluoride-class-action.com/wp-content/uploads/appendix-b-bruce-spittle-fluoride-fatigue.pdf

Categories: Uncategorized Tags:

Port Angeles Fluoridation Case Heard by Supreme Court

February 23rd, 2010 jamesrobertdeal No comments

Fluoride & Our Kidneys

February 22nd, 2010 jamesrobertdeal No comments

Fluoride and Kidneys

Fluoride plays perhaps more mischief with the kidneys than with any other organ.

See this excellent summary of the literature by Carol Clinch.

“One of the strongest physiological effects of fluorides in drinking water (e.g. hydrofluorosilicic acid) is in the kidney, a point to consider in light of increased rates of kidney failure during recent decades.

http://fluoride-class-action.com/wp-content/uploads/carol-clinch-2009-fluoride-and-kidneys.pdf

Kidney disease markedly increases an individual’s susceptibility to fluoride toxicity. In healthy adults, the kidneys are able to excrete approximately 50% of an ingested dose of fluoride. However, in adults with kidney disease the kidneys may excrete as little as 10 to 20% and young children may only excrete 15% of an ingested dose – thus increasing the body burden of fluoride and increasing an individual’s susceptibility to fluoride poisoning (e.g. renal osteodystrophy). 

Categories: Fluoride Articles, Kidneys Tags:

Lead In Pipes

February 22nd, 2010 jamesrobertdeal No comments

In 1986 the EPA greatly reduced the amount of lead allowable in water pipes, plumbing solder, and brass fittings.

However, lead is still allowed in all of these provided notice is given.

See: http://fluoride-class-action.com/wp-content/uploads/epa-1988-lead-solder-ban-except-with-disclosure.pdf.

Categories: Fluoride Articles, Lead Tags:

Update 2-19-10

February 20th, 2010 jamesrobertdeal No comments
2-19-10 3:41 pm

I WANT TO WRITE A RESPONSE TO THIS INACURATE PRO-FOUORIDE BRIEF. I NEED YOUR HELP

http://fluoride-class-action.com/wp-content/uploads/answer-to-brief-of-nine-amici-from-dental-serv-found-of-wa-and-dental-ass-water-and-fluoride-sci-committee.pdf

It is riddled with errors, and I need to point them out.

Please help me pick it apart. I have some good stuff about kidney disease and lead. I need something about how bad arsenic, any arsenic, is bad.

It is best to find authoiries in the 2006 NRC Report, because its credibility is very high. Or any article by one of the Twelve who wrote the 2006 NRC Report. Instant credibility, and that means judicial notice. The Court can take judicial notice of clear scientific principles at any point, even on appeal. 

The Washington Dental Service Foundation (WDSF), Washington State Dental Association (WSDA), and Water Fluoridation Science Committee (WFSC) filed an answer to the IAOMT Brief. It includes page after page of scientific arguments, issues, and scientific documents not presented to the Trial Court, including fluoridation endorsements from numerous agencies, and a lengthy article entitled “Water Fluoridation and the Environment,” by Howard F. Pollick. If the opposition is bringing forward scientific information, then the Nine Amici should be allowed to do so as well.

I must add that the above Answer written by WDSF, WSDA, and WFSC is riddled with illogical and unscientific statements regarding lead and kidney disease. 

Regarding lead:

To illustrate: The Brief acknowledges that almost half of tanker loads of scrubber liquor contain a little arsenic and a little lead. They say there is already some arsenic and some lead in the water coming from other sources, so it is acceptable to add a little more. Fluoride dissolves pretty much everything, including lead. New pipes, fittings, and solders contain lead, and old ones contain up to 30% lead. Lead solder for use in plumbing was not outlawed until 1986, so this might explain why lead continues to show up in water fountains in old Seattle schools, at levels up to 1,600 ppb, 80 times the EPA MCL of 20 ppb. See Appendix D attached, “Lead-Tainted Water in Seattle Schools Stuns Parents,” Or click on http://www.seattlepi.com/health/180495_leadwater02.html.

I am looking for the article that says that lead levels are generally higher in children who drink fluoridated water.

Regarding kidney disease this is what I would say:

Even a healthy kidney can only excrete 50% of fluoride consumed, so it accumulates in us all and in the kidney. A weakened kidney stores fluoride it cannot excrete, furthering the downward death spiral. 2006 NRC Report page 140.

See summary of scientific literature done by Carol Clinch, “Fluoride and Kidneys,”which cites to page 140 of the 2006 NCR Report.
http://fluoride-class-action.com/wp-content/uploads/carol-clinch-2009-fluoride-and-kidneys.pdf

Carol Clinch, “Fluoride and Kidneys,” cites to page 140 of the 2006 NCR Report, which says:

In patients with reduced renal function, the potential for fluoride accumulation in the skeleton is increased. It has been known for many years that people with renal insufficiency have elevated plasma fluoride concentrations compared with normal healthy persons and are at a higher risk of developing skeletal fluorosis.” National Research Council. (2006).Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. National Academies Press, Washington D.C. p140.

Carol, why don’t you write a draft brief on this subject?

I have been told that lead levels are higher in the systems of kids that drink fluoridated water. II would like to present an amicus brief on that subject.

See the Clinch article:

http://fluoride-class-action.com/wp-content/uploads/carol-clinch-2009-fluoride-and-kidneys.pdf

Read the poor response to the IAOMT Brief here:

http://fluoride-class-action.com/wp-content/uploads/answer-to-brief-of-nine-amici-by-city-of-port-angeles.pdf

Almost every sentence of this document is wrong or misleading or based on incorrect assumptions. That’s why I want to write a new brief reviewing the quality of the writing in that brief.

Read my IAOMT Brief here. All the Appendices are here too:

http://www.box.net/shared/iedafn1jr7

Read the City’s motion to strike the IAOMT Brief here:

http://fluoride-class-action.com/wp-content/uploads/citys-motion-to-strike-citizens-briefs-1-29-10.pdf

Read my defense of the IAOMT Brief here:

http://fluoride-class-action.com/wp-content/uploads/response-of-nine-amici-to-motion-to-strike-iaomt-brief-2-19-10-final.pdf

So write your own draft brief. It does not have to be long. It is best if it covers just one subject. Or just send me articles with paragraphs that introduce them. That constitutes a brief. It is never to late to introduce scientific arguments into a legal-scientific case. Why? because science is a form of law. It falls within the category of “natural law.” It is analagous to a dictionary. It is never too late for a judge to look up a word in the dictionary, or a concept in the encyclopedia, or to take judicial notice of convincing science.

The weekend is here, so spend it writing!

The writer of the poor brief says on page 5 that at the low levels of concentration, fluoride is a water additive, not a drug. I need to rebut that.

I am also looking for an attorney who can sign the man briefs that are starting to come in. The Supreme Court has a sort of quota on how many briefs one attorney can write.

So use my format on previous briefs and put your content into it.

Come on guys, the Supreme Court hearing is on Tuesday the 23rd. I would like to hand deliver a stack of new amicus briefs. Actually, I think that we can submit briefs after the hearing.

This is the final reply of the Nine Amici to the City’s motion to strike it. Use it as your template. Send me an e-mail, and I will send it to you in word so you can edit it easier.

Categories: Uncategorized Tags:

Update 2-17-10

February 17th, 2010 jamesrobertdeal No comments

THE LATEST NEWS:

Tuesday, February 17, Noon

Please read the final version of my defense against having our brief stuck.  

Click hear to read the February 5, 2010, IAOMT brief, including all Appendices such as D-1 through D-103.

Click here to read Appendices A, B, C, and D.

Please send me journal articles about the harms. I need articles about how fluoride accumulates, about how it affects the kidney especially when it is failing and initiatives a death spiral, about penetration of the brain barrier, placental barrier, and mammary barrier. Quantities of fluoride consummed by diabetics and sweaty athletes, sweaty workers, and sweaty soldiers. 

Send me these articles ASAP. Please write an introduction to the article and briefly summarize it. In the introduction say what you believe about fluoridation and how it might be affecting the health of your family. The title for your introduction is: “Amicus Brief.” 

That’s right. Write your own “Amicus Brief.” I will give you the wording on this web page within 24 hours. The Court WILL look at this, and it WILL go into the record.

We should use this case as a rallying point for our movement. We have momentum, and we should build it into more momentum.

All across the country we should be sending Freedom of Information Act requests for documents. Click here for a sample.

We should follow it up with an explanation of what the water district is doing wrong and a Notice of Potential liability and Not to Destroy Documents.

Remember, we can win this thing, and the time is NOW!! (I rarely use exclamation points. I’m trying to stir you to action. STIR!!

Yes, they have all the money. But we have all the good ideas.

Start writing and sending me those Amicus Briefs.

And here is another alternative: There are now Nine Amici on the IAOMT Brief. Feel free to join the IAOMT brief. Pretty soon it will be the Fifty Amici. Send a description of your interest in the issue. If you are part of a group, talk about the group’s interest in the issue. You can form an on-the-spot group. This is a good time to be forming de-fluoridation groups.

I also need attorneys who are willing to sign briefs. The Supreme Court is not likely to allow me to submit more briefs under my own name.

Just send me the briefs, and I will connect the briefs up with the lawyers, who may want to revise the briefs with their own insights.

The hearing is February 23 up in Skagit County, so hurry up!

Remember, we can win this thing, and the time is NOW!! (I rarely use exclamation points. I’m trying to stir you to action. STIR!!

Yes, they have all the money. But we have all the good ideas.

Start writing and sending me those Amicus Briefs.

Just send me the briefs, and I will connect the briefs up with the lawyers, who may want to revise the briefs with their own insights.

Categories: Fluoride Articles, Initiatives Tags:

Toxicological risks from novel forms of fluoride in drinking water

February 16th, 2010 jamesrobertdeal No comments
 
 

Doug Cross, BSc, CBiol, EurProBiol, FSB
 

 

February 15, 2010
James,
 
You said you wanted a fast response torespond to your Amici brief, so here goes!
 
I have attached a paper that I have (coincidentally) just completed – on the toxicological and ecotoxicological implications of the wholesale release of novel forms of fluoride in the environment. This emphasises a rather neglected field in this debate – the synergistic effect of fluoride on aluminium toxicity and the potential enhancement of the dangers of neurodegenerative diseases. I have not yet decided where to publish it – haven’t even had time to give it a thought – but if this is helpful, please feel free to use it.
 
The paper contains a very important addition to the fluoride debate (last paragraph on page 1 and following short section, page 2) - clear evidence that fluoridated water at 1.3 ppm has no prophylactic effect in a population whose only source of fluoride was its water supply. Over a period of 7,000 years, the communities affected had terrible teeth, and fluoridated toothpaste did not exist.
 
A professional coleague is a retired dentist who spent years veneering the fluorosed teeth of wealthy Arabs in Bahrain. He has personally examined some of the archaeological remains in the Bahrain Museum, and vouches for the fact that the condition of the teeth and bones there was caused by fluorosis, so we have independent professional verification of the evidence published by Frolich and Littlejohn cited in the text.
 
Hope this is helpful to you.
 
Best regards
 
Doug Cross
 
 

Washington Constitution

January 31st, 2010 jamesrobertdeal No comments

In their complaint when they sued the city of Port Angeles, the Citizens claimed their rights under the Washington  Constitution were in general were being violated. They cited specifically Article 1, Sections 1, 3, and 11:

ARTICLE I
DECLARATION OF RIGHTS

SECTION 1 POLITICAL POWER. All political power is inherent in the people, and governments derive their just powers from the consent of the governed, and are established to protect and maintain individual rights.

SECTION 3 PERSONAL RIGHTS. No person shall be deprived of life, liberty, or property, without due process of law.

SECTION 11 RELIGIOUS FREEDOM. Absolute freedom of conscience in all matters of religious sentiment, belief and worship, shall be guaranteed to every individual….

They could also have cited these additional sections:
SECTION 4 RIGHT OF PETITION AND ASSEMBLAGE. The right of petition and of the people peaceably to assemble for the common good shall never be abridged.

SECTION 5 FREEDOM OF SPEECH. Every person may freely speak, write and publish on all subjects, being responsible for the abuse of that right.

SECTION 7 INVASION OF PRIVATE AFFAIRS OR HOME PROHIBITED. No person shall be disturbed in his private affairs, or his home invaded, without authority of law.

The fact that the Medical Independence Act was attached to the Complaint and that it mentioned these constitutional rights is important because the City has tried to strike any portion of the amicus briefs which mention constitutional issues.

Categories: Constitutional Issues, Initiatives Tags:

Water Safety Additives Act

January 31st, 2010 jamesrobertdeal No comments
Categories: Documents, Initiatives Tags:

RAP 2.5 Rules of Appellate Procedure

January 31st, 2010 jamesrobertdeal No comments

Rule 2.5 of rules of Appellate Procedure is important to this case. The City has made a motion to strike sections of the Citizens’ amicus briefs, specifically “those portions of amici’s briefs containing claims and arguments [and attachments] not presented to the trial court and to strike and not consider the attachments related to those claims and arguments.” … “[N]one of those issues and attachments … were presented to the trial court and no factual record was made before the trial court. … [T]here are no factual findings of the trial court related to the new issues …; there are no assignments of error related to those … issues; andthe issues are being raised for the first time by amici in this Court.”

My response will be first, that these issues were raised because the two initiatives were attached to the complaint; second, that the Court can take judicial notice of many of the facts raised because they are now recognized scientific fact; third, because RAP 2.5 says ”… that a party may raise … for the first time in the appellate court: … manifest error affecting a constitutional right.

My third argument is the most important. There are constitutional issues at stake. One has the right not to be forced to consume the drug/poison fluoride because it violates his constitutional rights to liberty, freedom, personal bodily integrity, and privacy. One has the right to vote on such issues under the First and Fourteenth Amendment rights of free speech and the right to petition one’s government.  

RULE 2.5 
CIRCUMSTANCES WHICH MAY AFFECT SCOPE OF REVIEW

    (a) Errors Raised for First Time on Review. The appellate court may
refuse to review any claim of error which was not raised in the trial
court
. However, a party may raise the following claimed errors for the
first time in the appellate court
: (1) lack of trial court jurisdiction,
(2) failure to establish facts upon which relief can be granted, and (3)
manifest error affecting a constitutional right. A party or the court may
raise at any time the question of appellate court jurisdiction. A party may
present a ground for affirming a trial court decision which was not
presented to the trial court if the record has been sufficiently developed
to fairly consider the ground. A party may raise a claim of error which was
not raised by the party in the trial court if another party on the same
side of the case has raised the claim of error in the trial court.
    (b) Acceptance of Benefits.
    (1) Generally. A party may accept the benefits of a trial court
decision without losing the right to obtain review of that decision only
(i) if the decision is one which is subject to modification by the court
making the decision or (ii) if the party gives security as provided in
subsection (b)(2) or (iii) if, regardless of the result of the review based
solely on the issues raised by the party accepting benefits, the party will
be entitled to at least the benefits of the trial court decision or (iv) if
the decision is one which divides property in connection with a dissolution
of marriage, a legal separation, a declaration of invalidity of marriage,
or the dissolution of a meretricious relationship.
    (2) Security. If a party gives adequate security to make restitution if
the decision is reversed or modified, a party may accept the benefits of
the decision without losing the right to obtain review of that decision. A
party that would otherwise lose the right to obtain review because of the
acceptance of benefits shall be given a reasonable period of time to post
security to prevent loss of review. The trial court making the decision
shall fix the amount and type of security to be given by the party
accepting the benefits.
    (3) Conflict With Statutes. In the event of any conflict between this
section and a statute, the statute governs.
    (c) Law of the Case Doctrine Restricted. The following provisions apply
if the same case is again before the appellate court following a remand:
    (1) Prior Trial Court Action. If a trial court decision is otherwise
properly before the appellate court, the appellate court may at the
instance of a party review and determine the propriety of a decision of the
trial court even though a similar decision was not disputed in an earlier
review of the same case
.
    (2) Prior Appellate Court Decision. The appellate court may at the
instance of a party review the propriety of an earlier decision of the
appellate court in the same case and, where justice would best be served,
decide the case on the basis of the appellate court’s opinion of the law at
the time of the later review.

Categories: Constitutional Issues Tags:

Topical vs. Systemic

January 10th, 2010 jamesrobertdeal No comments

Fluoride does seem to harden enamel, but how does it do it? All the research concludes that the mechanism is topical, as with the application of toothpaste, mouthwash, or gels, not through drinking fluoridated water or eating fluoride pills or fluoridated salt. This article is from Caries Research, Systemic vs. Topical Fluoride, 2004, 38:258–262, DOI: 10.1159/000077764.