In a perfect world, high quality science would inform politics and policy. Science cannot determine policy by itself because there are also value judgments and trade-offs that need to be negotiated. At the least, however, policy should be consistent with the best available science.
We, of course, don’t live in a perfect world. Too often politics and ideology seem to inform, or corrupt, science. It is so much easier to just cherry pick the science that seems to confirm what you already believe, than to go through the process of changing your beliefs to accommodate the evidence. The stronger the ideology, the greater the motivated reasoning used to defend it, without apparent practical limit. For core ideologies that are part of someone’s identity, there does not appear to be any amount of evidence that will change their beliefs.
Anti-scientific motivated reasoning is often codified in specific organizations, institutions, or professions. Political parties are essentially organized ideologies, and when that ideology is predominantly pseudoscientific, you have organized pseudoscience. (more…)
Fluoridated water: Panacea or poison? Probably neither.
One of the overriding themes of the Science Based Medicine blog is to use rigorous science when evaluating any health claim – be it medical, dental, dietary, fitness, or any other assertion put forth with the intention of improving one’s health. Once the scientific evidence is evaluated as to efficacy, there are other criteria which must be taken into consideration, such as ease of administration, costs, possible adverse effects, and so on. Benefits have to be carefully weighed against risks to properly determine any appropriate course of action. For example, if a new pill is developed which is significantly better at , say, managing hypertension than existing medications, but it kills 10% of patients taking it, it obviously would not be the drug of choice. Conversely, if a proposed treatment, say homeopathy, is touted as being 100% safe with no side effects, but has absolutely zero benefits, it too would not be a recommended treatment. It’s a complicated and often ambiguous algorithm, and is imperfect due to the impossibility of attempting to quantify non-quantifiable values and qualities. (more…)
We dentists are an evil group of sociopaths. When we’re not trying to kill you or give you chronic diseases such as multiple sclerosis with our toxic mercury saturated fillings, we are advocating for the placement of rat poison/industrial waste (i.e. fluoride) in your water supply by our governmental overlords. What is up with us?
The problem is, we’re failing miserably. Even after more than 150 years of placing silver amalgam restorations in our patients, thereby saving untold numbers of teeth, reducing pain and suffering, and improving chewing ability for millions upon millions of people, there is still no evidence worth a damn that shows any correlation or causative effects for any known disease or condition. And with fluoride, after adjusting fluoride levels in municipal water supplies throughout the U.S. and in many places world wide for over sixty years, after adding fluoride to toothpastes and mouthwashes, and giving fluoride treatments to patients in our offices, the only nefarious result we have obtained is the significant reduction of dental decay with its concomitant savings of billions of health care dollars and untold pain and suffering for our patients. Man, we can’t do anything right.
Now, with the help of the American Academy of Pediatrics (AAP), there’s a new strategy.
The following post is a collaborative effort between myself and science-based dentist Grant Ritchey DDS. Dr. Ritchey is a co-host of the always excellent The Prism Podcast, most recently interviewing Dr. Robert Weyant and discussing how to teach critical thinking to dental and medical students. He can also be found on Twitter at @SkepticalDDS. Dr. Ritchey has written for SBM before on the topic of cranial osteopathy in dentistry.
As a pediatric hospitalist, I don’t deal with issues of dental health very frequently. Sure I see plenty of oral mucosal lesions, as occur during a primary herpes outbreak or a case of Kawasaki disease, but not many problems with the teeth themselves. I do admit a few dental abscesses here and there that need to be cooled down with IV antibiotics prior to definitive surgical drainage. And as a hospitalist that sees a fair amount of newborns, I also discover the occasional natal tooth. That’s when a baby is born with a tooth, usually a central mandibular incisor, having already erupted.
But as a pediatrician, I care deeply about the overall health of children and the network of caregivers that surround them. I guess you could say that I take a holistic approach, but I would prefer that you didn’t. Although we aren’t dentists, pediatricians recognize that oral health is integral to the well-being of a child and that many long-term dental maladies develop during the first two decades of life, often before the first tooth even appears. The most common, and one which non-dentist health care providers can have a major impact on, is the development of dental caries, or “cavities”. (more…)
There is an obvious survival advantage to the emotion of disgust – we should fear putting unhealthy, tainted, contaminated, or poisonous substances into our bodies. Emotions, however, are a double-edged sword. They are an effective evolutionary mechanism for motivating creatures to engage in certain behavior, but they also tend to be crude and undiscriminating – inadequate to deal with our complex modern society.
A dispassionate consideration of objective scientific evidence is the optimal strategy for deciding on which foods and substances are safe to consume, but it is far easier to scare people about toxins than to reassure them with data. We see this frequently with the anti-vaccine movement, and also with anti-fluoridation attitudes. It is easy to scare people with the idea that there are “chemicals” in our drinking water.
One company, San Diego Pure Water, seems to have made such scaremongering into a marketing strategy. Their website is full of articles and videos claiming that fluoride is the “the greatest fraud that has ever been perpetrated.”
There is a movement in the US to oppose a public health measure that is backed by impressive evidence showing it is safe and effective, as well as highly cost effective. For as long as the government has supported this health measure, there have been those opposed to it, claiming (against the evidence) that it is unsafe, ineffective, and represents a violation of personal freedom and the right to refuse an unwanted medical intervention. I could be talking about vaccines and the anti-vaccine movement, but in this case I am talking about the fluoridation of public water supplies and the antifluoridation movement.
This social debate (there isn’t much of a scientific debate) crops up in the news every now and then – mostly prompted by an antifluoridation activist or group making noise, or by a local referendum to block fluoridation in a community. Recently there has been a Harvard study making the rounds of social media, Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis. The actual findings of the study do not show that there is any risk to public water fluoridation (if anything, they show that it is safe), but the study was seized upon by antifluoridation activists and distorted for their propaganda purposes. Unfortunately, the internet is now fertile ground for the spreading of propaganda.
The NYS Coalition Opposed to Fluoridation put out a press release distorting the findings of the study. Their press release (“Harvard Study Finds Fluoride Lowers IQ – Published in Federal Gov’t Journal”) was then printed as a science news item by many online news outlets. Reprinting press releases, without any editorial filter, is a cheap and easy way to add news-like content to your website. The Sacramento Bee, for example, published the press release under their “News” tab. Near the top of the page, in small print, they did put a disclaimer (which is better than most sites):
This section contains unedited press releases distributed by PR Newswire. These releases reflect the views of the issuing entity and are not reviewed or edited by the Sacramento Bee staff. More information on PR Newswire can be found on their web site.
That’s better than nothing, but I wonder how many people reading the press release will notice and read the disclaimer. In my opinion, a news outlet should not reprint press releases sent out from advocacy organizations clearly intended to promote an agenda. They especially should not print them under the banner of “News.” The disclaimer is not adequate. The spreading of this “news item” around Facebook and other social media demonstrates this.