Fluoridation has historically been "sold" using photos of rampant Baby Bottle/Sippy Cup Tooth Decay (BBTD) even though the photos are misleadingly described as ordinary "dental decay" and even though fluoridated water does not kill the bacteria that, 1) colonize on tooth surfaces, 2) thrive and multiply on sugars, and 3) pass their acidic waste onto the dental enamel causing the damage we call tooth decay.
In other words, Baby Bottle/Sippy Cup tooth decay is caused by high levels of strep mutans bacteria that thrive and multiply on the steady sugars supplied by sipping fluids rather than drinking out of a cup. The bacteria's acidic waste first ravages the primary teeth and continues right on with the permanent teeth.
In January 2000, Dr. Kathleen Thiessen, Senior Scientist at SENES Oak Ridge Inc. Center for Risk Analysis, reviewed the 1993-94 California Oral Health Needs Assessment for the City of Escondido and stated in her critique:
1) "Any study of the effectiveness of a particular measure in preventing dental caries must control for the presence of dental sealants, or the results will be meaningless." and,
2) For preschool children, "Š any evaluation of the effectiveness of various measures must control for the occurrence of BBTD vs. other types of decay." and,
3) "In addition, if children with BBTD are thought to be more prone to developing caries in other teeth (Dental Health Foundation, 1997, p 9 ) then history of BBTD vs. caries incidence should be examined for preschool and elementary children."
Note: and elementary children! The dental literature is clear that elementary school children with a history of BBTD are indeed more prone to decay in permanent teeth. Controlling or adjusting for history of BBTD in elementary school children should be the norm but is never done! By not making this adjustment, studies can and do show a (false) fluoridation benefit for elementary children!
Sincerely,
Maureen Jones, Archivist
Citizens for Safe Drinking Water - Keepers-of-the-Well.org
Fluoride Action Network - FluorideAlert.org
1205 Sierra Ave.
San Jose, CA 95126
408 297-8487
Documentation from the published dental literature supporting the above statements:
J H Shaw. "Causes of Dental Caries; Microbial Agents" New England Journal of Medicine, Vol. 317 No 16, Oct. 15, 1987.
When rats are delivered by cesarean section and maintained under sterile conditions, they can be kept in a germ-free state for generations. Carious lesions do not develop when germ-free rats are fed a caries-producing diet.
Bacteriocin typing of S. mutans has indicated that the mother is a major source of oral infection in her infant. ŠWhen all carious lesions in pregnant women were restored and they followed good dietary practices, their salivary S. mutans counts decreased to low levels. When these low counts were maintained during their infants' early lives, their salivary counts of S. mutans were also low and they acquired fewer carious lesions than other children of comparable age. When children in the same study became infected with S. mutans before the age of two years, they had approximately eight times as many carious lesions as children in whom S. mutans was not detected until the age of four.
Auge, K. Denver Post Medical Writer. Doctors donate services to restore little girl's smile. The Denver Post, April 13, 2004. (Note: Denver, CO has been fluoridated since 1954.)
"Sippy cups are the worst invention in history. The problem is parents' propensity to
let toddlers bed down with the cups, filled with juice or milk. The result is a sort of
sleep-over party for mouth bacteria," said pediatric dentist Dr. Barbara Hymer as she
applied $5,000 worth of silver caps onto a 6-year-old with decayed upper teeth. Dr.
Brad Smith, a Denver pediatric dentist estimates that his practice treats up to 300 cases a
year of what dentists call Early Childhood Caries. Last year, Children's Hospital did
2,100 dental surgeries, many of which stemmed from the condition, Smith said. The
condition crosses economic boundaries, but Smith said it is especially pervasive among
children in poor families.
Allukian, M. Symposium Oral Disease: The Neglected Epidemic - What Can Be Done? Introduction: Journal of Public Health Dentistry, Vol. 53, No 1, Winter 1993. "Oral Disease is still a neglected epidemic in our country, despite improvements in oral health due to fluoridation, other forms of fluorides, and better access to dental care. Consider the following: 50 percent of Head Start children have had baby bottle tooth decay." (Bullet #5 of 8.)
Shiboski CH et al. The Association of Early Childhood Caries and Race/Ethnicity Among California Preschool Children. J Pub Health Dent; Vol 63, No 1, Winter 2003.
Among 2,520 children, the largest proportion with a history of falling asleep sipping
milk/sweet substance was among Latinos/Hispanics (72% among Head Start and 65%
among non-HS) and HS Asians (56%). Regarding the 30% and 33% resultant decay
rates respectively; Our analysis did not appear to be affected by whether or not
children lived in an area with fluoridated water.
Barnes GP et al. Ethnicity, Location, Age, and Fluoridation Factors in Baby Bottle Tooth Decay and Caries Prevalence of Head Start Children. Public Health Reports; 107: 167-73, 1992.
By either of the two criterion i.e., two of the four maxillary incisors or three of the four maxillary incisors, the rate for 5-year-olds was significantly higher than for 3-year-olds. Children attending centers showed no significant differences based on fluoride status for the total sample or other variables.
Kelly M et al. The Prevalence of Baby Bottle Tooth Decay Among Two Native American
Populations. J Pub Health Dent; 47:94-97, 1987.
The prevalence of BBTD in the 18 communities of Head Start children ranged from 17 to 85 percent with a mean of 53%. The surveyed communities had a mixture of fluoridated and non fluoridated drinking water sources. Regardless of water fluoridation, the prevalence of BBTD remained high at all of the sites surveyed.
Weinstein P et al. Mexican-American parents with children at risk for baby bottle tooth decay: Pilot study at a migrant farmworkers clinic. J Dent for Children; 376-83, Sept-Oct, 1992.
Overall, 37 of the 125 children (29.6 percent) were found to have BBTD. Compliance in putting fluoride drops in bottle once a day was identical between BBTD and non BBTD groups.
Von Burg MM et al. Baby Bottle Tooth Decay: A Concern for All Mothers. Pediatric Nursing; 21:515-519, 1995.
"Data from Head Start surveys show the prevalence of baby bottle tooth decay is about three times the national average among poor urban children, even in communities with a fluoridated water supply."
Tiberia MJ, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dentistry 2007 May-Jun;29(3):201-8. PMID: 17688016 [PubMed - in process]
PURPOSE: The purpose of this study was to determine family characteristics, beliefs, and habits that contribute to early and severe caries in young children in Canada. METHODS: A survey was administered to: (1) parents of 139 children diagnosed with early childhood caries (ECC) in 5 pediatric dentistry practices in Canada over a 33-month period (group 1); and (2) parents of all normal referrals (carious and noncarious children) in one of the practices over a 3 month period (group 2). Group 2 prevented studying an exclusive or polarized population, and allowed direct comparison between children with decoy and without decoy. The survey responses were compared with caries rates in the children, determined by dental examination, to detect important correlations of family and child factors with the disease level. Chi-square and logistic regression analyses described the strength of the relationships. RESULTS: Parent responses provided information on: (1) demographics; (2) economic status; (3) birth order; (4) parental education; (5) payment methods; (6) feeding and weaning history; (7) fluoride history; (8) food habits; (9) hygiene; (10) behavior; and (11) medication use. Caries presence and severe caries was linked to: (1) leaving the bottle with a child while sleeping; (2) having problems brushing a child's teeth; (3) prolonged holding of liquids in the mouth; and (4) being Caucasian. The authors did find that bottle use in general and having a difficult child were protective influences against decay. CONCLUSIONS: The factors providing the most caries risk are: (1) being left with a bottle while sleeping; (2) parents having problems brushing the child's teeth; (3) holding liquids in the mouth for prolonged times; and (4) ethnicity.
Pit and Fissure Tooth Decay and Fluoridation
"Fluoride primarily protects the smooth surfaces of teeth, and sealants protect the pits and fissures (grooves), mainly on the chewing surfaces of the back teeth. Although pit and fissure tooth surfaces only comprise about 15% of all permanent tooth surfaces, they were the site of 83% of tooth decay in U.S. children in 1986-87."
The Oral Health of California's Children A NEGLECTED EPIDEMIC: Selected
Findings and Recommendations from the California Oral Health Needs Assessment
of Children, 1993-94.
"Because the surface-specific analysis was used, we learned that almost 90 percent of the remaining decay is found in the pits and fissures (chewing surfaces) of children's teeth; those surfaces that are not as affected by the protective benefit of fluoride."
Letter, August 8, 2000, from Jeffrey P. Koplan, M.D., M.P.H. Director Centers for
Disease Control and Prevention (CDC) Atlanta GA to Congressman Kenneth Calvert,
Chair, Subcommittee on Energy and Environment, Committee on Science, Wash DC.
"Nearly 90 percent of cavities in school children occur in the surfaces of teeth with vulnerable pits and grooves, where fluoride is least effective."
Facts From The National Institute of Dental Research. Marshall Independent Marshall,
Minnesota. May 28, 1992.
"Let me begin by saying that fluorides are most effective in preventing decay on the smooth surfaces of teeth. However, the chewing surfaces of posterior are not smooth. They have crevices and pits and it is our experience that fluorides don't really get access to these pitted areas."
Hearings: Subcommittee of the Committee on Appropriations, House of Representatives.
March 1984. Dr. Harald Loe, Director of the National Institute of Dental Research.
"Fluoridation and the use of other fluorides have been successful in decreasing the prevalence of dental caries on the smooth surfaces of teeth. Unfortunately, these efforts have much less effect on dental caries that occur in the pits and fissures of teeth (particularly on the biting surfaces of teeth) where more than 85 percent of dental caries now occur."
Toward Improving the Oral Health of Americans. Public Health Reports. 108: 6, Nov '93
"The program focused on four caries-prevention techniques: sealants, a plastic-like coating applied to the chewing surfaces of back teeth and to pits and fissures on the sides of teeth (these surfaces are most prone to decay and ones which fluorides cannot protect adequately)".
Dental study upsets the accepted wisdom. Science News. Vol. 125, No. 1. Jan.7, 1984.
"It is estimated that 84% of the caries experience in the 5 to 17 year-old population involves tooth surfaces with pits and fissures. Although fluorides cannot be expected appreciably to reduce our incidence of caries on these surfaces, sealants can."
Preserving the perfect tooth. Editorial. J American Dental Assn Vol. 108. March 1984.
"The type of caries now seen in British Columbia's children of 13 years of age, is mostly the pit and fissure type. Knudsen in 1940, suggested that 70 percent of the caries in children was in pits and fissures. Recent reports indicate that today, 83 percent of all caries in North American children is of this type. Pit and fissure cavities aren't considered to be preventable by fluorides, they are prevented by sealants."
Fluoridation: Time For A New Base Line? A.S. Gray, DDS, FRCD(C), J Canadian Dental
Asso. No. 10, 1987.
"Even though half of all kids are cavity-free today, 80% of the decay that does occur appears on the chewing surfaces of their back teeth, where fluoride isn't as effective."
Dr. Stephen Moss, chairman of pediatric dentistry at New York University. Tooth
Report, American Health March 1989.
"Although systemic and topical fluoride use has been shown to be highly effective in prevention of caries on smooth surfaces, enamel surfaces with pits and fissures receive minimal caries protection from either systemic or topical fluoride agents."
Pediatric Dentistry Infancy Through Adolescence, Third Edition, p. 485. Sr Editor J R Pinkham, DDS MS (Head of Pediatric Dentistry, U of Iowa College of Dentistry) Published by WB Saunders Co. 1999 ISBN 0-7216-8238-3.
"It has been recognized for years that fissured occlusal surfaces are the most vulnerable to caries. With the continuing caries decline among children, caries is becoming a disease of the fissured surfaces as the rate of approximal caries development continues to decline faster than that of overall caries experience. Occlusal surfaces are also those least protected by fluorides, so the case for sealant as a complementary procedure to fluoride is even stronger. As of the early 1990s, at least 83% of all decayed or filled surfaces in the permanent teeth of 5-17-year-olds were in pit-and-fissure surfaces.
Dentistry, Dental Practice, and the Community 5th Edition. Brian A Burt BDS MPH PhD
and Stephen A Eklund DDS, MHSA, DrPH, WB Saunders Co. 1999 ISBN
0-7216-7309-0
"The most effective prevention of caries on the smooth surfaces of teeth is fluoride. However, the chewing surfaces of molars are most vulnerable to cavities because they can be hard to clean, and difficult for fluoride to penetrate. Dental sealants are the most effective means of caries prevention on these surfaces."
Schaefer J et al. Open Mouth Survey of Third Graders, Nebraska Health and Human
Services System, Nebraska 2005.
"Regardless of the degree or perfection of calcification of the enamel of the teeth examined, the decays as found are practically limited to the pits and fissures; or, put in another way, to those areas upon which there are interruptions in the surface continuity." Note: Of the 733 cavities counted and tabulated by McKay in Pima Indian School at Sacaton Arizona, Bruneau Idaho, and Towner Colorado, ninety five percent (95%) were in the pits and fissures.
Frederick S. McKay, DDS. Original Communications, Dental Cosmos August 1929.
Compiled and sent by Maureen Jones, Citizens for Safe Drinking Water 408 297-8487.
