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posted by Fnord666 on Monday December 16 2019, @07:36AM   Printer-friendly

In other words, what happens when a population suddenly stops taking fluoride in their drinking water, like Juneau's citizenry did?

Now, thanks to a recent study led by first author and public health researcher Jennifer Meyer from the University of Alaska Anchorage, we've got new insights into the subsequent effects.

In the study, Meyer assessed Medicaid dental claim billing records for two groups of children and adolescents aged 18 or under.

One of these groups represented what the researchers call "optimal" community water fluoridation (CWF) exposure: 853 non-adult patients on behalf of whom Medicaid dental claims were filed in 2003, years before the fluoride cessation began in 2007.

The other group was made up of 1,052 non-adult patients from families who similarly met Medicaid income requirements, and who made the same kind of dental claims almost a decade later, in 2012.

[...] "By taking the fluoride out of the water supply... the trade-off for that is children are going to experience one additional caries procedure per year, at a ballpark (cost) of US$300 more per child," Meyer explained to KTOO News.

Source: https://www.sciencealert.com/here-s-what-happened-when-a-city-in-alaska-took-fluoride-out-of-its-drinking-water

Reference: Jennifer Meyer, Vasileios Margaritis & Aaron Mendelsohn, Consequences of community water fluoridation cessation for Medicaid-eligible children and adolescents in Juneau, Alaska, BMC Oral Health, https://doi.org/10.1186/s12903-018-0684-2


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  • (Score: 2, Troll) by Anonymous Coward on Monday December 16 2019, @07:57AM (63 children)

    by Anonymous Coward on Monday December 16 2019, @07:57AM (#932736)

    This is so weak it makes me question the value of fluoride in the water... I mean comparing the dental bills charged to medicare per patient in 2003 vs 2012 and saying the entire difference found in an arbitrary age subgroup is due to a change in water fluoridation policy in 2007?

    It is really difficult to even take this seriously, I feel like I am reading the onion.

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  • (Score: -1, Troll) by Anonymous Coward on Monday December 16 2019, @08:06AM (31 children)

    by Anonymous Coward on Monday December 16 2019, @08:06AM (#932739)

    It is really difficult to even take this seriously, I feel like I am reading the onion.

    Or, you are khallow. Kinda a toss-up. You never see a commie drinking water, do ya, Mandrake?

    • (Score: -1, Flamebait) by Anonymous Coward on Monday December 16 2019, @08:19AM (1 child)

      by Anonymous Coward on Monday December 16 2019, @08:19AM (#932742)

      Shouldn't you be busy coming up with some Trump themed ASCII art to spew forth into the interwebs?

      • (Score: 0, Troll) by Anonymous Coward on Monday December 16 2019, @08:38AM

        by Anonymous Coward on Monday December 16 2019, @08:38AM (#932750)

        We are coming for you, Fluoride troll! When we find you, the first thing we will do is remove all your fillings. Then we will force you to have single payer health insurance, that covers dental and vision. You will have no where to go, no where to hide! You poor, poor pathetic excuse for a human being. Oh, and BTW, Trump is dying. Walter-Reed trip still not explained, but it wasn't a lack of fluoride in his water.

    • (Score: 4, Interesting) by FatPhil on Monday December 16 2019, @08:56AM (28 children)

      by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @08:56AM (#932757) Homepage
      I've never suspected khallow of cowardly hiding behind anon in order to cover up beliefs which he knows might be unpopular.

      khallow is also smarter than this poster appears to be. khallow quite often takes the same facts as the rest of us (such as increased costs of some mass intervention), and concludes - based on an internally consistent worldview, though one quite different from that of some other posters - that those costs are not worth it, a conclusion consistent with his worldview. Different axioms lead to different conclusions, we shouldn't be surprised, but that's not an example of ignorance or illogic, merely sociopathy.

      This loon, however, is arguing with simple reproducable facts, that's a completely different disease. This is so-loopy-he-has-to-be-trolling territory.
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      • (Score: 0) by Anonymous Coward on Monday December 16 2019, @09:06AM (27 children)

        by Anonymous Coward on Monday December 16 2019, @09:06AM (#932759)

        You said: "They didn't "compare dental bills charged to medicare" at all. "

        Sorry, but you have no place deciding who is intelligent or not. This is exactly what they measured, and can be verified by anyone with 8th grade reading comprehension. Then you said they measured an isolated effect!

        Wtf is going on with this site?

        • (Score: 5, Informative) by FatPhil on Monday December 16 2019, @09:14AM (26 children)

          by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:14AM (#932762) Homepage
          Nope. They counted procedures. That's the "one more per year". That's their scientific conclusion. They then converted that to a bottom line dollar value for those who don't know how expensive procedures are. That's an economic corollary.
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          • (Score: 0) by Anonymous Coward on Monday December 16 2019, @09:37AM (14 children)

            by Anonymous Coward on Monday December 16 2019, @09:37AM (#932766)

            Nope. They counted procedures.

            There is no "nope"... why do you keep denying that that they compared prices?

            Data were secured from all Medicaid dental claims records submitted during 2003, three years prior to cessation, and 2012, six years post-cessation, for all Medicaid-eligible children aged 0 to 18 years residing in the 99801 zip code who were examined by a dentist

            [...]

            We manually counted the number of caries-related claims (Level 3 claims) and the total dollar amount charged by the service provider for these restorative treatments. For example, if a patient had a one-surface primary amalgam restoration and a three-surface anterior resin restoration during the study year, then this patient’s experience would be summed as two caries-related procedures, along with the total caries-related costs for these specific procedures.

            [...]

            The mean caries-related treatment cost for the 0- to 18-year-old age cohort was significantly higher in the suboptimal CWF group than that in the optimal CWF group ($593.70 vs. $344.34, p < 0.0001) without adjusting for inflation. According to the U.S. Department of Labor Consumer Price Index [47], the inflation rate increased an estimated 24.75% between 2003 and 2012. Therefore, the increase in inflation-adjusted provider service charges in caries treatment costs associated with CWF cessation for the 0- to 18-year-old age group was + 47%, or $161.84.

            And as I said, inflation *in dental expenses* is much higher than CPI. So this entire increase in expenses is illusory. Even according to the official government stats inflatoin was twice as strong as what they assume:

            Between 2003 and 2012: Dental services experienced an average inflation rate of 4.03% per year. This rate of change indicates significant inflation. In other words, dental services costing $334 in the year 2003 would cost $476.63 in 2012 for an equivalent purchase. Compared to the overall inflation rate of 2.49% during this same period, inflation for dental services was higher.

            https://www.in2013dollars.com/Dental-services/price-inflation/2003-to-2012?amount=334 [in2013dollars.com]

            And government stats always understate inflation so they can screw over anyone with an inflation-adjusted pension or social security.

            • (Score: 5, Informative) by FatPhil on Monday December 16 2019, @09:45AM (13 children)

              by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:45AM (#932770) Homepage
              Nope, Donny, just plain nope.

              Read the paper. Get someone to read it for you if that's too hard. Notice, right at the start where it should tell you what they're going to be doing, they actually tell you what they're going to be doing! And what they're going to be doing is "A bivariate analysis (Mann-Whitney U test) of the mean number of caries procedures performed per client".
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              • (Score: 0) by Anonymous Coward on Monday December 16 2019, @10:10AM (5 children)

                by Anonymous Coward on Monday December 16 2019, @10:10AM (#932775)

                So you deny what I quoted above comes from the paper? To be clear, I do not deny that they counted number of fillings, etc. The level of this communication has dropped below zero though, even dumber people than who wrote this paper are apparently reading it and taking it to be important.

                • (Score: 3, Funny) by FatPhil on Monday December 16 2019, @11:53AM (4 children)

                  by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @11:53AM (#932800) Homepage
                  I deny what you quoted above comes from the paper.

                  I do that because it does not come from the paper.

                  See how logic works?
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                  • (Score: 0) by Anonymous Coward on Monday December 16 2019, @04:01PM (3 children)

                    by Anonymous Coward on Monday December 16 2019, @04:01PM (#932875)

                    Wow! This is peak idiocy I've seen on this site. Those quotes come directly from this paper.

                    • (Score: 0) by Anonymous Coward on Monday December 16 2019, @09:37PM (1 child)

                      by Anonymous Coward on Monday December 16 2019, @09:37PM (#933018)

                      Both of you quoted the paper. You each are suffering from what you accuse the other of.

                      • (Score: 0) by Anonymous Coward on Monday December 16 2019, @11:43PM

                        by Anonymous Coward on Monday December 16 2019, @11:43PM (#933077)

                        Where do you see that?

                    • (Score: 2) by FatPhil on Tuesday December 17 2019, @10:28AM

                      by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday December 17 2019, @10:28AM (#933224) Homepage
                      Ctrl-F in the paper did not find even the first 2 words of your quote, let alone the whole thing.

                      Are you confusing the paper for the article?

                      My quotes have almost exclusively come from the paper.
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              • (Score: 3, Insightful) by JoeMerchant on Monday December 16 2019, @02:56PM (6 children)

                by JoeMerchant (3937) on Monday December 16 2019, @02:56PM (#932855)

                What they're not doing is considering the "root cause" of the caries.

                It would seem to be a safe assumption that underlying diet and other factors remained relatively constant during the period studied, however- that rate of one cavity per year might (just might) drop equally dramatically with a dietary change such as elimination of sugar-soft-drinks from the childrens' diet as it does with fluoridation of the municipal water.

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                • (Score: 0) by Anonymous Coward on Monday December 16 2019, @04:04PM (2 children)

                  by Anonymous Coward on Monday December 16 2019, @04:04PM (#932877)

                  Sugar doesn't matter so much as pH. I wonder if the fluoridation process affects the pH at all.

                  • (Score: 3, Informative) by HiThere on Monday December 16 2019, @07:23PM (1 child)

                    by HiThere (866) Subscriber Badge on Monday December 16 2019, @07:23PM (#932972) Journal

                    pH is important, but is relatively independent. The water is carried in metal pipes, so the pH will be normalized. The fluoride salts that get embedded in the teeth are less sensitive to acid than what they replace.

                    That said, I'm not really impressed with the study. It's not long term enough. There is evidence (I'm not sure how good) that excess (whatever that means) fluoride will eventually affect the chances of getting cancer. But you'd need a longitudinal study lasting for at least 30 years to pin that down. (Probably 40 or 50 years would be better.) But that's going to have a lot more effect on medical costs than a few extra cavities.

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                    • (Score: 0) by Anonymous Coward on Monday December 16 2019, @11:47PM

                      by Anonymous Coward on Monday December 16 2019, @11:47PM (#933078)

                      No, it isn't independent, the reason sugars are bad for your teeth is because bacteria in your mouth eats it and shits out acids that lower the pH. Sugar on its own does nothing to enamel.

                      Good grief, the nonsense in this thread.

                • (Score: 2) by FatPhil on Tuesday December 17 2019, @10:22AM (2 children)

                  by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday December 17 2019, @10:22AM (#933223) Homepage
                  Absolutely true. One of the many other foibles the US is internationally known for is its obsession with sweet foodstuffs and drinks. However, that goes back decades (and even counting decades, I might run out of fingers). I remember seeing a %sugar in breakfast cereals survey for the UK vs. the US about 25-30 years ago, and your average was higher than out highest even back then. I genuinely don't think there's been significant change upwards in the US in that time literally because you had almost nowhere to expand into. Until you've started just having cotton candy for brekky nowadays.
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                  • (Score: 2) by JoeMerchant on Tuesday December 17 2019, @03:48PM (1 child)

                    by JoeMerchant (3937) on Tuesday December 17 2019, @03:48PM (#933307)

                    One of the many other foibles the US is internationally known for

                    Meanwhile, the UK is known for their excellent teeth and fine cooking. /s

                    The U.S. is chronically guilty of letting the packaged food and many other industries abuse the population, seemingly profits are our king.

                    started just having cotton candy for brekky nowadays

                    It's pretty ridiculous here, but more often it's disguised as "health bars," or "designer coffees" - things that at first glance you wouldn't expect to be hiding so much high fructose corn syrup. It really is the corn farming lobby (think: Monsanto) that has done the most damage over the past 50 years.

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                    • (Score: 2) by FatPhil on Tuesday December 17 2019, @04:29PM

                      by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday December 17 2019, @04:29PM (#933316) Homepage
                      No idea what the UK is legitimately known for nowadays, I left there decades ago for a reason. I'm happy to credit them with their incredible ability to stab themselves in the foot, but it's not as impressive as some other countries' methods of pedal punishment.
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          • (Score: 2, Insightful) by Bot on Monday December 16 2019, @10:20AM (10 children)

            by Bot (3902) on Monday December 16 2019, @10:20AM (#932776) Journal

            One more per year is a propaganda conclusion, does not specify how many per year so you cannot tell the increase in percentage, nor can you tell when one becomes adult, so no data overall.
            The cost is also unspecified, it is the gouging for the uninsured or the actual price for the all powerful insurance company?

            The truth is that fluoridation is getting people to absorb the byproduct of agricultural additives, and when multinational companies have billion dollar interests in a procedure, sudy by professor x is to be taken with a boulder if salt even if it states that 2+2 is 4.

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            • (Score: 2, Informative) by Anonymous Coward on Monday December 16 2019, @10:41AM (5 children)

              by Anonymous Coward on Monday December 16 2019, @10:41AM (#932778)

              In the paper they report an actual number per year. For ages 0-6 this is 1.55 +/- 3.89 in 2003, and 2.52 +/- 4.35 in 2012.

              Also keep in mind, this is "a variable *reflecting* the number of caries-related procedures", not the actual number of cavities found.

              The costs were: " Current Dental Terminology (CDT) codes used for procedure and service claim reimbursement, were publicly available for referencing procedure types and costs for both study years."

              They also say "Medicaid made adjustments in the form of increases for dental claims CDT codes in 2009 and 2010, which may have resulted in Medicaid reimbursement increases even without provision of more services. From 2003 to 2008, the Medicaid dental reimbursement rate would largely have been the same (i.e., remained unchanged). Therefore, since this study spanned 2003 and 2012, provider service fees were the more consistent metric and could also be adjusted for inflation, thus allowing comparisons."

              • (Score: 2) by Hyperturtle on Monday December 16 2019, @02:32PM (4 children)

                by Hyperturtle (2824) on Monday December 16 2019, @02:32PM (#932844)

                What shocks me is that I never had cavities. I drank flouridated water growing up.

                I can't imagine a scenario when the entire community experiences any amount of additional cavity related procedures -- and that it's considered OK.

                Why do they have any? I mean I get that kids eat candy. And drink sugar water. And that adults do, too and that behaviors can be hard to stop.

                I only stopped drinking typical soda and eating regular candy after I moved out from my parents and had to actually buy that stuff on my own. Eventually, I got it only on sale, and now I dont' even buy it except on occasion (like the holidays). None of those changes in adult behaviors assisted me as a kid.

                My question then is if kids are having some greater value of *additional* cavity related procedures -- it doesn't matter to me how many they had before. Why is it that there are numerous cavities to begin with? The fact that it's accepted on average that kids are getting multiple cavity related procedures... it sounds to me like there's something else in the water out there that's causing a problem, and it's not flouridation. It's probably fructose or other dissolved sugars added to the other drinks kids are consuming. The fact that "medicaid" is references as opposed to "anonymized heatlh insurance billing data" makes me wonder if any stereotypical dietary issues are present as well. I won't get into them, but it's no secret that food deserts are often without healthy (or maybe more accurately, less-bad-for-you) options on a regular basis. Even less so in quantities that are affordable for families leveraging medicaid.

                Maybe some scientist somewhere should study tooth decay in the unlikely scenario that kids are prevented from drinking sugary carbonated beverages while allowing to eat their regular junk food of choice--just enforce the drink limits. Maybe also account for fruit juice consumption; much of it is high sugar naturally, but there are also beverages that have many added sugars in addition to being acidic to begin with. There aren't too many 'basic' fruit juices (grape juice is the only thing that comes to mind as being somewhat neutral in regards to teeth).

                • (Score: 2, Interesting) by Anonymous Coward on Monday December 16 2019, @04:08PM (1 child)

                  by Anonymous Coward on Monday December 16 2019, @04:08PM (#932880)

                  I had a bad fever and got put on antibiotics when I was about two, ever since I had weak enamel. I eat zero sweets and always had fluoridated water, doesn't matter.

                  • (Score: 2) by dry on Tuesday December 17 2019, @07:41AM

                    by dry (223) on Tuesday December 17 2019, @07:41AM (#933204) Journal

                    I got put on tetracycline for over a year due to acne, ruined my teeth and my gut biome. I've also always had a problem with grinding my teeth.

                • (Score: 0) by Anonymous Coward on Tuesday December 17 2019, @02:30AM (1 child)

                  by Anonymous Coward on Tuesday December 17 2019, @02:30AM (#933121)

                  These are poor kids (article mentioned Medicaid), and, sadly, all that this implies.

                  Probability of less parental supervision.
                  Less preventative care like dental cleanings.
                  Old worn out toothbrush.
                  etc.

                  There is an LA area dental school that partnered with the LA Unified School District that claims massive improvements in the dental health of the children participating in the program. But, not all poor kids have access to / have parents that know they have access + sufficient time off work to take advantage. One of the perks the school lists is free toothpaste and toothbrushes for participants.

                  • (Score: 2) by Hyperturtle on Friday December 20 2019, @02:38PM

                    by Hyperturtle (2824) on Friday December 20 2019, @02:38PM (#934642)

                    I agree that a lot of the things a kid can benefit from involving parental access to things is wildly disproportionate across incomes, social classes, and the various places they may live.

                    Growing up, it was a big deal for my mom to take a day off from work to shuttle me around to whatever doctor office or the dentist. It was always the same doctors/dentist; it wasn't like today where insurance can seem to change yearly if your employer "provides" it and changes each year based on costs. It was just a matter of her getting time off work to go.

                    I'd have to blow out a kidney or something just as bad if I ever hoped to stay home from school sick. (She even learned from the movie ET and watched me when taking my temperature so that I wouldn't cheat!!)

                    Anyway, blowing out a kidney isn't the same as sugar coating my way to the dentist. We had flouridated water where I grew up, but as a teenager we moved to more of a non-incorporated area and had some very metallic and mineral infused well water. I never did learn what all the contents of that water was (I don't think they ever paid to test it -- just that they paid a whole lot for an in-line iron filter followed by an in-line water softener).

                    I have to wonder if the introduction of that well water had any benefit; I was young enough to still have teeth coming in, but not so young that I could benefit (or not) from drinking it.

                    I haven't read or even seen any studies about mineral content of well water and the effects that may have on bone and tooth development for non-adults of any specicies, let alone humans -- it could very well be that hard water is a benefit for dogs and cats and anything that gnaws on a bone or something hard, in addition to kids getting more chomping resiliency.

                    Makes sense if it would; and how about that, someone somewhere did do a study: https://www.medicalnewstoday.com/articles/324910.php [medicalnewstoday.com]

                    Maybe utility provided tap water that is aggressively filtered is not so great, flouridated or not, when it comes to being healthy, but of course water with little dissolved solids sure beats whatever is in Flint, Michigan's water.

                    I recently read that lead exposure in drinking water for both children and adults--even adults that already are 'formed' as far as the brain is concerned -- are placed at a much greater risk for developing demetia and Alzeimer's as they age.

                    Rather than go to a news site, here's a headline from a source of lead info... https://www.lead.org.au/fs/fst48.html [lead.org.au] Whatever is making the rounds in the news today about lead exposure and dementia seems to be a well known fact already, but studies are being done to correlate that across wider population as well as, of course, medicare records.

                    It seems that Medicare in the US might be one of the best places to mine for data when it comes to societal health issues affecting people that depend on the government to access non-polluted water sources. I can see how that can go off the rails quickly if Google or Amazon or some profit seeking entity gets their hands on it. If you can't trust your government, you probably can't trust the intentions of for-profit companies with no qualms about ensuring your insurance company knows you have pre-existing conditions or likely-to-develop conditions, quite possibly caused by government spending cuts...

            • (Score: 4, Informative) by FatPhil on Monday December 16 2019, @11:50AM (3 children)

              by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @11:50AM (#932799) Homepage
              > does not specify how many per year

              FFS. Before and after figures are right there in the article. Does being so clue-resistent hurt? It ought to, in order to discourage such a maladaptation.
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              • (Score: 1, Troll) by Bot on Monday December 16 2019, @12:57PM (2 children)

                by Bot (3902) on Monday December 16 2019, @12:57PM (#932819) Journal

                You should read again what I wrote, I was talking about the propaganda conclusion, which is the one going into the media. Had I written "article" but I didn't.

                And my own conclusion implies the article is correct. The only thing I got it wrong is the price which is the one asked to the insurance (so the official reduced price, which might or not be subject to more bulk discounts), but again if you read, it was not a declaration but a question.

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                • (Score: 4, Insightful) by FatPhil on Monday December 16 2019, @01:46PM (1 child)

                  by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @01:46PM (#932832) Homepage
                  I read what you wrote, troll. You wrote:

                  > you cannot tell the increase in percentage

                  Yet you can tell, as they provided that data.

                  You also wrote:

                  > nor can you tell when one becomes adult, so no data overall.

                  Which is again utter bogosity - they say explicitly what ages they are considering, which happen to be almost universally adopted, so can actually be safely assumed most of the time.

                  If by "you cannot" you mean "I cannot", then please say that, however, it order to save us the effort of spoonfeeding you, please word it as "I cannot, as I'm too damn lazy to read the thing I'm commenting about, ".
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                  • (Score: 2) by Bot on Monday December 16 2019, @05:54PM

                    by Bot (3902) on Monday December 16 2019, @05:54PM (#932922) Journal

                    You are still talking about the article, I still talk about the conclusion in TFS. Its conclusion focuses one aspect and says nothing about how the situation for everybody in the place differed from the average situation in the country, all variables considered, because the study maybe doesn't consider them all as other commenters are pointing out.

                    And, again, the conclusion I wrote clearly bypasses the problem of determining how correct is the article.

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  • (Score: 0) by Anonymous Coward on Monday December 16 2019, @08:17AM (3 children)

    by Anonymous Coward on Monday December 16 2019, @08:17AM (#932741)

    Based on your comment I actually read over the article (my first opinion was the same). Seems there is a bit more in the article and the researchers claim the difference is significant among all age groups. The time differences are IMHO not really a problem if you just take the amount of procedures changed, if you put the current price tag on that you get a reasonable indication of costs.

    Let's assume the values the article mentions, 18 years times 1 extra procedure on average times $300 is $5400 per child (count a few hundred bucks extra if taking inflation into account). That's quite a bit of money that could have been saved for a few dollars.

    My main wonder is though if all these children were brushing with tooth paste which has fluoride added as well and if that doesn't have a greater effect than the fluoride added to the water (I checked for my country (the Netherlands) and it seems they don't add fluoride as well, but there is some residual natural fluoride from the water source).

    • (Score: -1, Troll) by Anonymous Coward on Monday December 16 2019, @08:22AM (1 child)

      by Anonymous Coward on Monday December 16 2019, @08:22AM (#932743)

      They compare prices in two arbitrary years in arbitrary age groups without even properly accounting for inflation in the price medicare will pay.

      There is nothing to take seriously here, it is GIGO. If they use the exact same method on a town that begins adding fluoride you will see them show dental expenses are greater after adding it.

      • (Score: 0, Informative) by Anonymous Coward on Monday December 16 2019, @08:29AM

        by Anonymous Coward on Monday December 16 2019, @08:29AM (#932745)

        "between 1998 and 2008 the increase in the cost of dental services exceeded that of medical care and far exceeded the overall rate of inflation"
        http://www.slate.com/articles/life/the_american_way_of_dentistry/2009/09/the_american_way_of_dentistry_2.html [slate.com]

        I knew this was the case just using common sense (the price of anything the government pays for inflates far faster than CPI), but there you go.

        This paper is written by retards, sorry. They have no idea what the numbers even represent.

    • (Score: 1, Interesting) by Anonymous Coward on Monday December 16 2019, @09:42AM

      by Anonymous Coward on Monday December 16 2019, @09:42AM (#932769)

      I have a hard time caring about this study knowing it is based on data from Juneau. In the same time frame there has been a lot of political stress due to various state issues (oil prices, feds fucking us harder than normal, and lack of jobs). So it could mean more people using medicare than they were before because of lack of other coverage, more people drinking their sorrows away, or people neglecting to go to the dentist (very expensive in AK) in the final Bush years due to the economy.

      Not to say any of that makes me doubt the data, seems interesting. But at the end of the day Juneau is just politicians, lobbiests, lawyers, and alcoholics. F em.

  • (Score: 5, Insightful) by FatPhil on Monday December 16 2019, @08:28AM (23 children)

    by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @08:28AM (#932744) Homepage
    Most studies are weak on their own, that's why you replicate. This one replicates the results from all the pilot studies that did the experiment in the opposite direction - detecting the benefits of adding fluorides to public water. Worldwide. Which confirmed the findings correllating natural fluorine levels with improved dental health. Worldwide. The posteriori is barely different from the priori here.

    Americans seem desperate to cling to anti-science at any cost, and this is just another example. I know this story would bring out what's effectively an anti-vax loon almost immediately, as I remember SN demonstrating a significant membership of that group last time there was a story along these lines.

    You're so willfully anti-science, you even deliberately misrepresent their findings. They didn't "compare dental bills charged to medicare" at all. They measured procedures done: "kids who were exposed to fluoride in their tap water had on average 1.55 caries procedures annually – but this jumped to 2.52" (Handy hint, the fact this is what they measured is also in the summary, but your fact-resistence is clearly Pro level and can glide past that ignorantly without even needing to dive into the article itself and ignore all it says too.)

    What are the implications of higher numbers of procedures? Higher costs. They're just spelling things out for the beancounters and the libertardians who demand nothing sould ever be spent on anything. Do you never wonder why no-one takes you lot seriously?
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    • (Score: -1, Troll) by Anonymous Coward on Monday December 16 2019, @08:32AM (7 children)

      by Anonymous Coward on Monday December 16 2019, @08:32AM (#932747)

      If you think this is science just because they collected some data and compared some numbers YOU are the problem. This is cargo cult science. No rational thought went into this paper.

      • (Score: 4, Insightful) by FatPhil on Monday December 16 2019, @08:43AM (6 children)

        by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @08:43AM (#932752) Homepage
        Given that you were unable to even *detect* the science in the article, I reckon your ability to refute it will be minimal, but I'll bite:

        If you see a problem with their science, identify it, and refute it, using equal or higher quality peer reviewed studies or metastudies.

        I love the fact that them measuring things before and after an isolated change - exactly what do you think they've not controlled for? - makes you consider this not science. You're carrying the wouldn't-know-science-if-it-landed-on-his-desktop-in-a-respected-peer-reviewed-journal torch with quite some pride.
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        • (Score: 0) by Anonymous Coward on Monday December 16 2019, @08:50AM (4 children)

          by Anonymous Coward on Monday December 16 2019, @08:50AM (#932754)

          An isolated change? There is no isolated change here. Lots of things changed in 11 years regarding dental practice, medicare policies, and prices. Also, it is obvious p-hacking of dates and age groups. Then even after the the underlying numbers they compare are simply incomparable.

          Standards have fallen so far and the education system must be so dumbed down for this to get published and taken seriously. And like I said, if this is the best evidence they can come up with for fluoridation then there is the something seriously wrong with that practice.

          • (Score: 2) by FatPhil on Monday December 16 2019, @09:03AM (3 children)

            by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:03AM (#932758) Homepage
            You measure developing ages, that's not p-hacking, that's standard practice in the field.

            Proof of the claim of p-hacking of dates requested. Yeah, they looked at a group before and a group after a change - obvious p-hacking to detect a difference across that change /sarc.
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            • (Score: 0) by Anonymous Coward on Monday December 16 2019, @09:40AM (2 children)

              by Anonymous Coward on Monday December 16 2019, @09:40AM (#932768)

              You measure developing ages, that's not p-hacking, that's standard practice in the field.

              So standard age groups are 0-6, 0- 7, 7-13, 13-18, and 0-18? No one comes up with age groups like that before looking at the data. Just like no one would only look at 2003 vs 2012 instead of all the data. If they didn't get the result they wanted there they would have paid for more years, etc.

              Also, you do not seem to understand what p-hacking is to begin with.

              • (Score: 3, Informative) by FatPhil on Monday December 16 2019, @09:59AM (1 child)

                by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:59AM (#932771) Homepage
                Pfft. 12/13 is absolutely standard as a cutoff for looking at deciduous teeth, and 18 as a cutoff for non-adults.

                > Just like no one would only look at 2003 vs 2012 instead of all the data. If they didn't get the result they wanted there they would have paid for more years, etc.

                You cannot say that with any certainty. They only looked at one before/after pair, and the data from those years was clear. They did not p-hack, as they did not look at any other years.

                It is you who does not understand p-hacking. You have to throw away data that's inconvenient in order to p-hack, they did no such thing. And even if they'd bought 3 years of data from each side of the change, which they didn't, and thrown away the least convenient 2 of each, which they didn't, their p-values would still have been significant (e.g. p<0.004, and p<0.001).

                You're making a claim of scientific fraud - that's a serious claim - you need serious evidence to back that up, and you have none (as there is none).
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                • (Score: 0) by Anonymous Coward on Monday December 16 2019, @10:08AM

                  by Anonymous Coward on Monday December 16 2019, @10:08AM (#932773)

                  You have to throw away data that's inconvenient in order to p-hack

                  That is wrong, look it up.

        • (Score: 3, Interesting) by sonamchauhan on Monday December 16 2019, @12:07PM

          by sonamchauhan (6546) Subscriber Badge on Monday December 16 2019, @12:07PM (#932804)

          I see a problem in cost calculation and interpretation.

          The authors calculated the increase in dental treatment cost using national CPI numbers. But CPI for Dental Services [in2013dollars.com] increased at a faster clip (43% versus 25% for the period in question).

          Second, they ignored the increasing abundance of dentists. In Alaska, the dentist-to-population ratio grew around 17% (give or take a couple percent) for the period in question:
          - 2002: 1 dentist for 1233 persons (source data: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449253/) [nih.gov]
          - 2012: 1 dentist to 1045 persons (source data: https://datausa.io/profile/geo/juneau-ak#category_trade. [datausa.io] Data collection year for '2014' report year)

          As cost of dental services, and supply of dentists, both increase faster than expected, it's natural there will be a tendency to over-treat. Quoting Upton Sinclair, "It is difficult to get a man to understand something when his salary depends upon his not understanding it." I recall my old dentist telling me he wasn't going to drill certain 'spots' on my teeth -- he said they would "re-mineralise". Another, younger, dentist treating a family member didn't seem to appreciate "re-mineralisation" much, being of the 'drill 'n fill' persuasion. Perhaps, in time the younger man will come around to the older dentist's views.

          To draw firmer conclusion, we'd need comparative data on changes in incidence of caries, and changes in the tendency to _treat_ caries, in the general population over the same timespan.

          But other than that, on the science I have no problems. This study's results are broadly as expected -- flourine toughens tooth enamel and I'd find it strange if there was no effect. But the study cannot answer a more serious question: what's the effect of that extra flourine (above background) circulating in your bloodstream over decades.

    • (Score: 0) by Anonymous Coward on Monday December 16 2019, @08:36AM (1 child)

      by Anonymous Coward on Monday December 16 2019, @08:36AM (#932749)

      "The mean caries-related treatment cost for the 0- to 18-year-old age cohort was significantly higher in the suboptimal CWF group than that in the optimal CWF group ($593.70 vs. $344.34, p  0.0001) without adjusting for inflation."

      This is comparing apples and oranges.. You have to be so ignorant about what you are measuring to even report this result.

      • (Score: 0) by Anonymous Coward on Monday December 16 2019, @08:40AM

        by Anonymous Coward on Monday December 16 2019, @08:40AM (#932751)

        It's Alaska, you moran! Different math up there, doncha know. (Seriously, what a maroon!)

    • (Score: 4, Interesting) by deimtee on Monday December 16 2019, @09:15AM (5 children)

      by deimtee (3272) on Monday December 16 2019, @09:15AM (#932763) Journal

      The evidence is that water fluoridation slightly reduces tooth decay. The benefit is almost zero in those who use a fluoride toothpaste and brush regularly, but significant in those who don't brush or don't use a fluoride toothpaste.

      Long term water fluoridation is also correlated with hip breakage in the elderly. 50% of ingested fluoride settles in the bones, where it increases bone density without increasing bone strength.

      The question is whether the elderly broken hips cost more or less than the fillings for kids who don't brush their teeth.

      --
      If you cough while drinking cheap red wine it really cleans out your sinuses.
      • (Score: 0) by Anonymous Coward on Monday December 16 2019, @09:20AM

        by Anonymous Coward on Monday December 16 2019, @09:20AM (#932764)

        That is not the question this paper attempts to answer at all...

      • (Score: 3, Informative) by FatPhil on Monday December 16 2019, @09:39AM (3 children)

        by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:39AM (#932767) Homepage
        The evidence herein is that fluoride significantly (in the statistical sense) reduces tooth decay procedures even amongst those who do use fluoridated toothpaste (2.35 vs. 2.02, p < 0.001; 2.68 vs. 2.01, p = 0.004). The efficacity of the intervention ('pqwer' in the statistical sense) will depend on the natural fluoridation level of the water, obviously.

        Youths will use their teeth more than oldies their hips, and that osteoporosis was only correlated with *suboptimal* flouride level (>2ppm, yes, too much is bad, everyone knows that, and has done since the 50s). If you're looking at the economics of healthcare, you've got to multiply everything by the number of years it's in use (and more, it gets complex, but only in ways that make grannies less important, I'm sorry to inform you).
        --
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        • (Score: -1, Troll) by Anonymous Coward on Monday December 16 2019, @10:56AM (1 child)

          by Anonymous Coward on Monday December 16 2019, @10:56AM (#932786)

          Power is not the efficicacy... Every one of your posts here is BS pseudoscience, just like this study..

          • (Score: 2) by FatPhil on Monday December 16 2019, @02:24PM

            by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @02:24PM (#932839) Homepage
            Power is just the likelyhood a test detects an effect if that effect actually exists, P(~H0|H1).

            If the natural fluoride level is near optimal levels, (a) the treatment is unnecessary, and will display no efficacy to the public; (b) the test will not detect any benefit.
            If the natural fluoride level is very low, (a) the treatment is useful, and will display high efficacy to the public; (b) the test will with high probability detect a benefit.

            Maybe we have different views on what the public view efficacity is. The above two 'if's tell me that it is directly related to the likelyhood a test detects the benefit, independent of the precise test used. You'd expect that just by looking at the effect size - both the public making their opinions, and the scientist making their measurements will be more likely to see a larger effect size.

            I was trying to map things between the public/scientist domains that are in some way equivalent - the public view on whether the effect is real vs. the scientific view on whether the effect is real (i.e. true/false values) - perhaps I should have just stuck with the effect size instead.
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        • (Score: 0) by Anonymous Coward on Tuesday December 17 2019, @08:05AM

          by Anonymous Coward on Tuesday December 17 2019, @08:05AM (#933206)

          Fluoride in bones is cumulative. >2ppm gives you breakages in short enough time frame to show up in the studies.
          Longer term exposure to lower levels is only just starting to come into play.

    • (Score: 2) by JoeMerchant on Monday December 16 2019, @03:05PM (4 children)

      by JoeMerchant (3937) on Monday December 16 2019, @03:05PM (#932858)

      Americans seem desperate to cling to anti-science at any cost

      Science is fine. I still prefer my non-chlorinated, non-fluoridated well water to the municipal piped stuff.

      If you want fluoride on the kids' teeth, get that at the dentist - pumping a steady drip into the whole population seems... insensitive to the poorly studied negative aspects of polluting our precious bodily fluids... O-P-E Code prefix locked. Switch all receiver circuits to CRM discriminators.

      --
      🌻🌻 [google.com]
      • (Score: 2) by FatPhil on Tuesday December 17 2019, @10:15AM (2 children)

        by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday December 17 2019, @10:15AM (#933221) Homepage
        Water can be naturally fluoridated to higher levels than the civic fluorination will strive for, so creating a "natural is better than doctored" narative is naive and flies in the face of reality. And the effects of high fluoride levels have been quite extensively studied, which includes levels that can occur naturally, and some negatives have been thoroughly debunked, whilst a few have been confirmed. Which is why civic programs typically top out at 1+/-.3 ppm, well short of the 2ppm that is considered detrimentally high.
        --
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        • (Score: 2) by JoeMerchant on Tuesday December 17 2019, @03:39PM (1 child)

          by JoeMerchant (3937) on Tuesday December 17 2019, @03:39PM (#933300)

          creating a "natural is better than doctored" narative is naive

          Natural variation ranges from zero fluoridation through higher levels than you might want, as does "natural" variation of other elements in water like salt, arsenic, lead, etc.

          Just because residents of the Colorado Rockies and airline pilots/crew receive a dose of radiation equivalent to a chest X ray every year isn't a good basis of argument to irradiate everyone with a chest X ray every year for little benefit.

          --
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          • (Score: 2) by FatPhil on Tuesday December 17 2019, @04:25PM

            by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Tuesday December 17 2019, @04:25PM (#933315) Homepage
            Which is precisely why that argument is never used.

            Put that match away, your petrol-soaked straw man will burn.
            --
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      • (Score: 0) by Anonymous Coward on Friday December 20 2019, @01:46PM

        by Anonymous Coward on Friday December 20 2019, @01:46PM (#934627)

        Also we should stop the disingenuous practice of calling all different things "fluoride". Sodium Fluoride is what occurs naturally and at the dentist's office. The chemical being added to civic water supplies is HydroFluoroSilicic Acid, a waste product from the phosphate mining industry.

    • (Score: 0, Troll) by Bot on Monday December 16 2019, @06:09PM

      by Bot (3902) on Monday December 16 2019, @06:09PM (#932933) Journal

      >Americans seem desperate to cling to anti-science at any cost

      This remark should be left to sociological contexts, which are not quite science themselves.

      --
      Account abandoned.
    • (Score: 0) by Anonymous Coward on Tuesday December 17 2019, @09:11AM

      by Anonymous Coward on Tuesday December 17 2019, @09:11AM (#933215)

      Oddly enough, I find people who use words like 'anti-science' tend to have a limited understanding of science to begin with. The word itself is somewhat of an oxymoron since it tends to refer to skepticism of an established view, when that is itself a fundamental component of science.

      Beyond that you demonstrate a specific misunderstanding here. A number (in this case procedures) jumping from 1.55 to 2.52 doesn't mean anything in a vacuum. You need to measure variance. In other words, how much would you expect your results to vary based on little more than noise? Turns out dental procedures have extremely high variance. The figures from the paper are 1.55 +/- 3.89 in 2003, and 2.52 +/- 4.35. So in other words, the change after fluoride was removed was well within the range as expected by statistical noise alone.

      The paper shows that there is minimal value to fluoridation of water. Also noteworthy is that the study was exclusively based around kids from very poor families. This sample is going to substantially over-represent the value of fluoride since it's biasing itself towards a sample that is going to have disproportionately poor eating habits, oral hygiene, and numerous other factors that increase the value of fluoridation. Ultimately it shows that there is negligible value to water fluoridation. Given potential side affects, it's probably not a smart idea.

  • (Score: 0) by Anonymous Coward on Monday December 16 2019, @08:51AM (2 children)

    by Anonymous Coward on Monday December 16 2019, @08:51AM (#932756)

    I want to see the sugar consumption numbers too. You might save even more by taxing sugar... ;).

    Anyway there are studies in other countries that show that fluoridation helps:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486317/ [nih.gov]
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883469/ [nih.gov]

    • (Score: 2) by FatPhil on Monday December 16 2019, @09:10AM

      by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Monday December 16 2019, @09:10AM (#932760) Homepage
      Nope - that's clearly modern leftie science, that'll never convince him, we need something from the glory days when commie science was being rejected as it should be.

      How about https://www.jstor.org/stable/4587515 from 1950? Or this summary of studies in the 1950s and 1960s: http://www.who.int/bulletin/volumes/84/9/05-028209.pdf ?
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    • (Score: -1, Troll) by Anonymous Coward on Monday December 16 2019, @09:12AM

      by Anonymous Coward on Monday December 16 2019, @09:12AM (#932761)

      Any of a million different things could have changed, attributing these differences to the fluoride is total cargo cult science. Especially when they ignore inflation when comparing prices! How can you do that and keep your job!

      Only a government employee could get away with this.