What I Say

Mental Caries

By Frank Gruber

The New York Times ran a fascinating story last week about capuchin monkeys in Venezuela that protect themselves from mosquitoes by rubbing each other with crushed millipedes.

The monkeys use a four-inch long millipede, Orthoporus dorsovittatus, which contains powerful chemicals, known to humans as benzoquinones, which repel insects.

Interestingly, although capuchin monkey life is generally quite hierarchical, when it comes to the public health issue of mosquito control, the monkeys are egalitarian and share the millipede secretions on an equal basis.

Although humans consider benzoquinones to be carcinogenic, apparently the monkey food and drug administration has determined that the cancer risk is not significant, either because of dosage or because the monkeys apply the crushed millipedes topically. Cancer is apparently not a problem among capuchin monkeys, who typically live into their thirties.

As the Times article points out, the monkeys have a medical need for controlling mosquitoes, which are not only annoying, but also vectors of a debilitating parasite, the bot fly.

What does this all mean to us here in Santa Monica?

Perhaps not much, except that capuchin monkeys apparently have a more sophisticated understanding of public health than three members of our City Council -- Ken Genser, Kevin McKeown, and our new mayor, Mike Feinstein.

Last week these three voted against fluoridating Santa Monica's water. Only six council members were present, however, and because of a parliamentary maneuver the Council will be able to vote on the question again when all seven members, including Pam O'Connor and new member Herb Katz, are in attendance.

Most of the astounding advances in health and longevity during the 20th century occurred not because of advances in clinical medicine, but because of governmental public health programs. These have included sanitary and hygienic measures such as water-purification by adding chlorine to drinking water; the mass use of vaccinations, including the use of live-virus serums; pure food laws and inspections; enrichment of common foods with vitamins and minerals, such as vitamin D in milk and iodide in salt; vector controls, etc.

One reason public health measures work is that they bring treatment to people who might otherwise not have access to health care or, for that matter, sanitary conditions.

Poor people, for instance, often cannot afford dental treatment for their children. Other children do not receive adequate dental care, including fluoride supplements, because their parents are not aware of their children's needs or motivated to fix them.

No one can hold children responsible for their healthcare choices.

Of course, science is an ongoing process. Public health professionals make choices on the best evidence available, but sometimes more research proves them to have been wrong. Certainly the use or overuse of pesticides and antibiotics has turned out to be a mistake.

Nonetheless, public health programs have been a huge success. Notwithstanding our culture's chronic anxieties about health matters, people on the whole live longer and healthier lives than they did 100 years ago. The Centers for Disease Control and Prevention recognized fluoridation as one of the ten great public health achievements of the 20th Century.

Because fluoridation has always been a controversial political issue there has been voluminous research about its effectiveness and its alleged risks.

I am not a scientist, but I researched the anti-fluoridation arguments myself this week on the Internet. What I found were scraps of science, an inconclusive study here or a labored hypothesis or extrapolation there, repeated over and over and often misrepresented, leavened with a fascinating jumble of left-wing and right-wing conspiracy theory.

Most of the anti-fluoride argument is based on characterizing the chemical, which naturally occurs to some extent in all drinking water (including Santa Monica's at up to half the concentration health professionals recommend), as toxic, something that can be true at concentrations far higher than what is used in drinking water to prevent tooth decay. Of course many beneficial substances are dangerous at high doses or when improperly used.

Opponents of fluoridation also claim that fluoride is associated with bone diseases like osteoporosis, but I found a study in the January 22, 2000 issue of The Lancet, the journal of the British Medical Association, that thoroughly debunks this theory. You can read it yourself at www.findarticles.com/cf_0/m0833/9200_355/59022624/p1/article.jhtml, but I warn you that The Lancet is well known to be a mouthpiece for the international aluminum and fertilizer industry conspiracy that has been ramming fluoride down our throats for 50 years.

A survey the British government commissioned to determine whether to begin fluoridation in Britain, released in October, found that there was no risk of harm from fluoridation.

What is true is that when water is fluoridated, dentists and parents must be mindful not to over supplement fluoride, so as to prevent the mottling of teeth. My family dentist, for instance, told me that he adjusts the amount of fluoride supplements he prescribes depending upon the source of each patient's water supply, taking into account not only whether the water is artificially fluoridated, but also the natural level of fluoride.

At the City Council hearing, Ken Genser said that he thought that fluoridation was probably safe, but he was going to vote against it because he thought people should have choice.

But children who are not getting enough fluoride do not have the choice of obtaining it by other means -- children cannot make these choices.

As for Kevin McKeown and Mike Feinstein, their anti-fluoridation votes were hardly surprising given that the Green Party has long opposed fluoridation around the world. (Try this search on Google: "Green Party Fluoridation" -- I came up with 655 hits.)

Ralph Nader is often quoted in the anti-fluoridation literature as having said that if "they" admit that fluoridation was a mistake, then "people would ask, and legitimately so, what else have they not told us right?" I have not found a primary source for this quote, but as recently as October, Nader appeared in San Antonio, Texas, to encourage people to vote against fluoridation there.

The point is that Nader and the Greens have made fluoridation and its imagined perils to be the apotheosis of the technology they resent. Our industrial society is bad, so fluoridation must be bad, too.

Without identifying anti-fluoridation as a Green Party issue, our local Greens, McKeown and Feinstein took this line at the City Council hearing.

At the hearing McKeown said that we could not be sure if fluoridation was safe until we have waited "seven generations." While "seven generations" has a nice mystical ring to it, he begged the question whether he meant seven generations with fluoridation or without it.

In the 1950's proverbial "little old ladies in tennis shoes" opposed fluoridation. Reacting against a confused world where America was no longer isolated from the world, where institutions and technology became more and more complex, the extreme right assumed that this changed world could only be the product of a demonic, Communist conspiracy, and fluoridation was explicable only as the product of this conspiracy.

Now when the Communist conspiracy has proved to have been ineffective, proverbial new-agers in hiking boots, calling themselves the extreme left, oppose fluoridation. But the motivations and the fears are the same.

Today's opponents of fluoridation also react against technology and globalization and change and a world much more complex than they like. They also blame modern problems on shadowy conspiracies. Conspiracies of government and industry and, apparently, dentists.

Tennis shoes or hiking boots. The footwear changes. The path doesn't.