Tuesday, January 27, 2015

An Open Letter to Anti-Fluoride Fearmongers Everywhere

I have a few words for my anti-fluoride fearmongering friends.

Full disclosure: My office is a fluoride-friendly practice. Still, out of respect for our patients’ autonomy, we would never force anyone to accept fluoride application against his or her will. It is a recommendation for which we are happy to discuss all of the potential benefits and risks in great detail before obtaining their informed consent to include it in any treatment plan.

I won’t delve into the decades of evidence-based research that demonstrate the safety and efficacy of fluoride usage in the prevention of dental caries, or explain the biochemical mechanisms by which its application reduces the incidence of tooth decay. That information is readily available online, in textbooks, and in libraries across the globe. With a few clicks of a button, anyone with an Internet connection can access the required reading of dental school syllabi and data from the most recent and advanced scientific studies around the world.

As much as I believe in the value of fluoride, I fully support individuals who are respectfully inquisitive of its effects, as well as other innovations in medicine, biotechnology, and public health. Skepticism is healthy, natural, and essential to sustaining intellectual discourse on important issues in an objective manner. There is just as much merit in exploring the benefits of fluoride as there is in investigating its long-term effects for potentially harmful consequences.

I don’t have a problem with doctors, patients, or activists who are vocal about their concerns with fluoride. No matter which side of the fence you’re on, I believe everyone has the right to express his or her opinion.

However, it’s one thing to raise awareness for a public health issue that you are passionately committed to by calling for more research into uncharted scientific territory. It’s another to fortify your claims through the proliferation of misleading publications; incite panic with scare tactics designed to invoke public hysteria; and make ignorant blanket generalizations about the medical, dental, and science professions that insult and discredit the education and experience of the individuals within those fields. 

When confronted by learned, experienced professionals armed with research and data that point out holes in your arguments, you retreat into false neutrality in an attempt to relinquish accountability for your grossly negligent statements. 

“I’m just putting the information out there.”
 “I’m entitled to my opinion.” 
“I just want to call attention to the subject and get people talking.”

Well, you now have my FULL attention. And, if you were looking to “get people talking,” you have DEFINITELY come to the right place.

I often hear the argument, “Even dentists can’t agree on whether fluoride is good or bad for you! as a reason to doubt our profession and the safety of fluoride. While it’s true that we have long been divided on the issue of fluoride, the one thing that we ALL recognize is that the overwhelming majority of research on the subject has shown fluoride to be a safe and effective means of reducing dental caries. 

Points of contention do not detract from the caliber of our training or knowledge in our field; rather, they indicate a willingness to allow differing professional opinions to peacefully co-exist as we all work toward the common goal of helping our patients achieve optimal dental and overall health.

Yes, there are unethical and careless health care professionals and scientists willing to bend the truth about their research, products, or services just to advance their careers. But what profession IS completely devoid of dishonesty? In EVERY industry, from engineering to entertainment, banking to beauty, you will find self-serving, money-hungry, or fame-obsessed scam artists eager to exaggerate or flat-out lie to their consumers in an attempt to cover up their mistakes, generate publicity, and get ahead.

You know what else I love hearing?

“Why should I take your word for it? Just because you have an advanced degree doesn’t make you an authority! Just because you’re a ‘doctor’ doesn’t mean you know everything!” 

Oh, it’s ON.

Let me tell you something about my profession. As a discipline that combines art, science, and service to others, dentistry is constantly evolving to include new findings, techniques, and approaches to care. I have never professed to know everything there is to know about dentistry—nor would any of my colleagues. A huge part of our commitment to being doctors is the pledge to engage in lifelong learning, which we honor through our participation in continuing education, involvement in research initiatives, and teaching rising generations of dental professionals.

I’ll never be an “expert” in the subject of dentistry because there’s no such thing when your field is in a constant state of growth and development. But, with education, hard work, and an open mind, I’ll probably get a LITTLE closer than someone who views my pursuit of higher learning as a wasted investment of time, effort, and money and thinks a degree is nothing more than a fancy piece of paper.

Life experience, travel, and human interaction are ALL necessary to expanding our horizons and achieving a greater understanding of the world we live in. But none of those things can act as a substitute for education. Education is the ONLY thing that can propel us forward as a society. It can bridge boundaries between opposing cultures and philosophies. It can unearth life-altering discoveries in myriad disciplines. And it can extinguish fear, hate, and ignorance.

But when people disrespect the importance of education, they have already lost.

Furthermore, when you accuse doctors and scientists of “bullying” you by presenting hard science and reflections stemming from firsthand clinical experience that counter your own personal views and things you’ve read online, you realize that your creative interpretation of that word dishonors victims of actual bullying. Vilifying academics and professionals for their contributions to humanity doesn’t make you a valiant crusader against obfuscation and elitism. It makes you glib.

All I ask is that if you’re going to take a strong stance on any health issue in one way or the other, at least do it with an ounce of integrity. Don’t cite data from scientific articles that you cherry-picked from your search engine results just because their titles contain words that sound like they might reinforce your standpoint without first carefully assessing the strength of the studies and their relevance to your argument. Even if a paper has been published in a well-reputed journal, this distinction is virtually meaningless if there are major flaws in the research methodology, multiple confounding variables or indicators of bias, and/or inappropriate statistical analysis and planning. 

Nobody is trying to take away your First Amendment rights. But if you insist on utilizing flawed science to support your position, expect to receive some harsh scholarly criticism from those of us who are well-versed in the material. When faced with your morally irresponsible dissemination of misinformation to the masses, it is not our job to make you comfortable. But it is our job to educate you.

Just doing my part,

Diana Nguyen, DDS

1 comment:

Dr. Lawrence M. said...

One of the best commentaries I have ever read. Thank-you for writing this so clearly. warm regards, Larry Stanleigh


PLEASE NOTE: When commenting on this blog, you are affirming that any and all statements, and parts thereof, that you post on “The Daily Grind” (the blog) are your own.

The statements expressed on this blog to include the bloggers postings do not necessarily reflect the opinions of the Academy of General Dentistry (AGD), nor do they imply endorsement by the AGD.