Inoculating Against Science-Denialism

This op-ed appeared in The Ottawa Citizen on February 10, 2015. 

There’s an illness sweeping its way across North America, one which has long-troubled the scientific community and baffled even the most seasoned medical expert.

This problem isn’t new, but was once considered primarily a threat to underdeveloped nations which have yet to fully reap the benefits of modern medical and technological advances: advances which turned once-fatal conditions into manageable, even curable, ones; advances which have saved countless lives and alleviated immeasurable suffering.

The regression, this outbreak of a highly-contagious, yet preventable, affliction, is what so troubles the medical and scientific communities alike: the ailment poses a direct risk to past public-health achievements. Though, when caught early, the condition can be treated and rectified, this particular malady is notoriously impenetrable once full-blown.

In mild cases, the afflicted are referred to as merely “vaccine-hesitant”: often new parents, genuinely interested in the health and welfare of their child, yet lacking the specific knowledge required to fully understand the importance of vaccination. Given their openness to discussion, early-intervention is key to full recovery. The combination therapy of patience and availability is often the best approach; A steady dose of evidence-based material is prescribed, and in most cases, the science-denialism will simply run its course.

Full-blown anti-vaccination sentiment, however, is one of science-denialism’s most potent manifestations. Not only is it highly contagious through typical transmission channels — fringe pseudoscientific websites; conspiratorial Facebook memes — but once airborne, this virulent ideology is nearly impossible to contain.

Television and radio tend to be the incurably-afflicted’s host of choice. Knowing media are under great pressure to avoid the appearance of bias, the stricken demand equal airtime, insist on presenting “the other side” of the argument.

Of course, there are no “two sides” in the matter of vaccinations; no “debate” to be had. There are proven, irrefutable facts regarding the safety and efficacy of vaccination, and there are lies. It’s that simple.

Still, the afflicted enthusiastically appear on-air armed with “research” acquired while earning a PhD in epidemiology from Google University. They offer “alternative” theories of disease, complete with “alternative” remedies like homeopathic nosodes. (Read: expensive placebos; snake-oil.)

Those beyond treatment, whose science-denialism hardens in the face of evidence, have, ironically, shown a developed immunity to facts. They aren’t driven by reason, but rather, by motivated reasoning — seeking only information fitting their beliefs, and when presented with details challenging those preconceived notions, they double-down on denial.

What, then, is the solution?

Though there isn’t a cure for science-denialism, there are steps which can be taken to mitigate the risk, keep the contagion in check. By refusing to give the infected a platform, be it through on-air interviews or quoting at length in print, media can prevent misinformation from benefitting the appearance of validity. Yes, every person is entitled to an opinion, but no, every opinion does not warrant equal merit.

Medical professionals and the science-minded can work to counter the pseudoscience by making themselves available to help the under-informed navigate the information minefield; providing resources to debunk anti-vaccine assertions; answering even the silliest question without judgement.

We must accept, too, that not every mind can be changed.

To quote Dr. Ben Goldacre: “You cannot reason people out of a position that they did not reason themselves into.”

But it’s always worth the shot.

Facts Matter In The Debate Over Water Fluoridation

It’s known as one of the top ten public health achievements of the 20th century; a “classic example of clinical observation leading to epidemiological investigation and community-based public health intervention;” Remaining “the most equitable and cost-effective method of delivering [health benefits] to all members of most communities, regardless of age, educational attainment, or income level.”

It’s a service that has benefitted Calgarians for two decades, backed by peer reviewed research and conclusive scientific data demonstrating the undeniable role it plays in the field of preventive medicine.

Raise a glass to Community Water Fluoridation (CWF), that is, while you still can. Because Monday, City Council will vote on Ald. Druh Farrell’s regressive motion to scrap Calgary’s water fluoridation program.

Armed with unsubstantiated claims and assertions gleaned from sources such as the discredited Fluoride Action Network, (or perhaps from the uninformed, and poorly researched, editorial in the Calgary Herald), Farrell and other luddites on city council are on the verge of rescinding an effective program based entirely on conspiracy theories and misinformation.

Claim: It’s not cost effective / other sources of fluoride do a better job at protecting teeth.

Fact: Despite the increase exposure to other sources of fluoride, “particularly from fluoride-containing dentifrices,” water fluoridation “continues to be the most far-reaching preventive [dental health] measure, [offering] an unmatched return on investment – saving $38 in dental treatment costs for every dollar spent.”

The U.S. Surgeon general reports that savings provided by CWF are “a rare characteristic for community-based disease prevention strategies. The mean annual per capita cost of fluoridation systems serving populations greater than 50,000 is [a mere]$0.68.”

Claim: The overall downward trend in cavity rates is due factors such as better oral hygiene, not water fluoridation / It doesn’t benefit adults.

Fact: Children living in communities with water fluoridation experience an 18% cavity reduction compared to those in communities without access to fluoridated water. Adolescents and adults in communities with fluoridated water experience an average of 25.6% and 20-40% respectively, than their counterparts living in communities without access to fluoridated water.

The U.S. Surgeon General reports “other evidence of the benefits of fluoridation comes from studies of populations where fluoridation has ceased … In Wick, Scotland, which began water fluoridation in 1969 but stopped it in 1979, the [cavity] prevalence in 5- to 6-year-olds … increased by 27 percent between 1979 and 1984. This was despite a national decline in [cavities] and increased availability of fluoride-containing [dental products].”

Claim: Studies show the risks of fluoridation outweigh the benefits / there is growing credible research demonstrating the dangers of ingesting fluoride.

Fact: Research into the effects of fluoridated drinking water “predates the first community field trials. Since 1950, opponents of water fluoridation have claimed it increased the risk for cancer, Down syndrome, heart disease, osteoporosis and bone fracture, acquired immunodeficiency syndrome, low intelligence, Alzheimer disease, allergic reactions, and other health conditions. The safety and effectiveness of water fluoridation [is regularly] re-evaluated, and no credible evidence supports an association between fluoridation and any of these conditions.”

Specifically, from a study done by Dr. David Locker, Community Dental Health Services Research Unit – Faculty of Dentistry, University of Toronto:

Regarding acute toxicity: “Fluoride is a poison in large doses but toxic levels cannot be achieved by drinking fluoridated water.”

Regarding bone health (osteoporosis; weak, brittle bones): “…the studies conducted to date do not provide systemic and compelling evidence of an adverse effect on bone.”

Regarding cancer: “… there is no reason to believe that exposure to fluoridated water increases rates of cancer either of bone or other body tissues.”

Regarding immune function: “…a review paper examined studies of fluoride and immune response … and found no support for the suggestion that fluoride affects immunity.”

Regarding mental development: “Recent studies emanating from China have claimed that children exposed to high levels of fluoride have lower IQ’s than children exposed to low levels. The two studies claiming such an effect are deeply flawed and provide no credible evidence that fluoride obtained from water or industrial pollution affects the intellectual development of children.”

The merits of water fluoridation are unmatched, and undeniable. Endorsed by Medical and Dental Associations worldwide, CWF is considered an investment in the future health and overall wellbeing of a given population.

Perhaps the most important, and overlooked, aspect of CWF is the extent to which it benefits the underprivileged members of society. As outlined in a 2009 report from the European Archives of Pediatric Dentistry, “water fluoridation is unmatched in its ability to reach all sectors of society, including those who are least likely to avail of other sources of fluoride or to access regular dental care … water fluoridation seems to reduce inequalities in children’s dental health across social classes in 5 and 12 year olds. Further research in this area has shown that water fluoridation benefits all social strata, and supports the finding that it may reduce inequalities in oral health, which is seen as one of fluoridation’s greatest strengths.”

This counteracts recent claims from Tea Party/Libertarians that CWF somehow deprives them of their choice to consume un-fluoridated water; that it violates their ‘personal freedoms‘.

Unlike the disadvantaged who have neither the money for, nor the access to, expensive dental procedures, those demanding ‘freedom’ and ‘choice’ are the very one who have the opportunity to exercise it.

If Calgarians are unsatisfied by the water provided by the city, they can opt to invest in a water filtration system, or chose to consume bottled water. It really is that simple.

Mayor Naheed Nenshi, a fellow fan of scientific research and hard evidence, has expressed his desire for input from the scientific community, medical experts, and the general public, regarding the future of Calgary’s water fluoridation program.

It’s my hope that the medical, dental, and scientific communities heed the Mayor’s call for expert, and informed, opinion. Whether City Council votes to end Calgary’s fluoridation program or not, it’s important that votes are based on accurate information and conclusive evidence.

Three months ago, Calgarians opted for progress and advancement when they elected Nenshi as mayor; let’s hope the 14 Aldermen chosen to represent the will of the people will continue to do just that, and keep the much beneficial water fluoridation program.

Cross-posted at