SoylentNews is people
SoylentNews
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.
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
(Score: 4, Insightful) by FatPhil on Monday December 16 2019, @08:43AM (6 children)
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.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Monday December 16 2019, @08:50AM (4 children)
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)
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.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Monday December 16 2019, @09:40AM (2 children)
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)
> 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).
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Monday December 16 2019, @10:08AM
That is wrong, look it up.
(Score: 3, Interesting) by sonamchauhan on Monday December 16 2019, @12:07PM
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.