UKCAF website

Lies, damned lies, and dental statistics!

Doug Cross
29th January 2015

"If you torture the data long enough,
it will confess to anything."

Am I the only scientist around who finds the dental statistics that the pro-fluoridation bully-boys use to frighten our Councillors so fascinating? Maybe it’s my unorthodox background - as a one-time Lecturer I taught statistics to undergraduate would-be biologists, whilst as an occasional Expert Witness I know just how rigorous a hostile barrister can be with disclosed evidence when trying to put one over on the Court!

I’ve spent many happy days going through the latest fascinating work of imaginative fiction on water fluoridation released by Public Health England (PHE) - its March 2014 Report. And I have to say that it’s a truly unique document - the most ingeniously contrived plot to manipulate the minds of the public (and even professionals) into believing the mediaeval myth that adding a seriously poisonous substance to the public water supply will cure almost all of the dental diseases known to man (or at least, to children.)

So I took a closer look at the PHE Report. What I found is quite staggering, but I warn you now, it’s not for the faint-hearted!

Blind faith and ignorance are not enough

I’m not a religious man, but I can spot people who are true believers pretty quickly. And PHE is the ultimate disciple of the Great God Fluoride. At least, I hope that that is its excuse for releasing this latest travesty of ‘evidence-based dentistry’. The possibility that it's just down to sheer incompetence or political manipulation is surely not something that we want to think about - is it? (If you think I'm overstating the case here, check out Brian Martin's analysis of the psychological and social basis of fluoridation fanaticism.)

If we are to embrace PHE’s absolute belief and convert to mass water fluoridation, whether it’s in Southampton or Bedford, or even in 'Hull, Hell and Halifax' (Good Lord, deliver us!), then we need real evidence, not blind faith and proselyting propaganda to guide us on how and where to use the stuff. If instead we're dealing with some seriously deranged and perverted Dr. Frankenstein’s running our public health establishment, then we need the Heavy Mob in to take these guys down as quickly as possible.

That familiar old Numbers Game.

Whenever I see numbers laid out in interesting scientific papers I get the old calculator fired up and check them out. More often than not, they’ll be wrong. This may be because they weren’t collected correctly in the first place, or because they’ve been mishandled with inappropriate statistical techniques after they were collected.

Cherry-picking the evidence to suit the required result, or 'selection bias'

But when someone sets out to compare what happens in one place to another, all sorts of naughty 'adjustments' are used to deceive the reader and give the wrong answer to the wrong people. To put it bluntly, people pick and choose which places to compare, looking for examples that appear to support their own cherished beliefs and ignoring stuff that inconveniently suggests that they might be wrong. It's called 'selection bias', and the PHE document is riddled with it.

So when numbers are compared in this way, I want to be sure that all of the numbers used are equally reliable. They must have been collected in the same way, and worked up using the right methods. Then, ALL of them must be compared, and not just those that have been carefully cherry-picked to give the answer that is required.

An epidemic of scientific fraud

Now you won't be comfortable with the idea that scientists can be fraudsters, but it's true. Far more than you might suppose - fiddle the figures; in fact a recent study found that 'most published research findings are false'? Check out John Ioannidis's famous paper and get a healthy wake-up call!

In another recent study published by Danielle Fanelli she records that in surveys asking about the behaviour of medical researchers, up to 72% admitted to having seen colleagues engaging in questionable research practices (fiddling the books). Curiously, far far fewer admitted to doing this themselves. This sneaky manipulation of data is, apparently, very often because they’ve been ordered to make sure that their ‘results’ are what some measly politician wants, to support his or her own pet project.

Unthinkable here in dear old Britain, of course. Really? As my quote at the start of this article notes, if you twist the numbers hard enough, you can 'prove' almost anything, and the medical (and of course, the dental public health) sector is by no means free from such trickery. But if PHE is in this game too, then we're looking at a seriously dangerous situation here.

The fix goes in

A real problem in medical science is that it's riddled with people who have - how shall I put it? - a somewhat flexible attitude towards telling the truth. Back in the 1950s Darryl Huff wrote a splendid little book. He called it called ‘How To Lie With Statistics’, and it has become the most popular book on this subject ever written. When I started to check out the PHE Report, I found that pretty well every little wriggle that Darryl described in his book was superbly demonstrated.

But even more impressively, PHE has even invented brand new ways of torturing the data to make it confess, and I really do recommend this splendid example of statistical chicanery to all Stats Lecturers for use in their classes. Your students will learn an enormous amount of really valuable ways to deceive, ways that I am sure will stand them in excellent stead throughout their entire career.

Just how deeply has the rot penetrated our health services?

But is this PHE Report the real problem, or does the sickness lie even deeper within the NHS itself? Being, perhaps, just a little obsessed after my first foray into the PHE Report, I wondered just how reliable is the most widely used source of basic information on children’s dental health in the UK.

So I started analysing the NHS’s National Surveys of Oral Health. These report on the state of the teeth of children of specific age groups in Local Authority areas throughout England. Since so much emphasis is placed on the rotten teeth of 5 year olds, I first checked out the 2011-12 figures, but my remarks below apply at least to some extent to other recent surveys.

"Your kids have the worst teeth in the Region!" Oh, really?

As our Councillors are all too well aware by now, when the kids in their areas are targeted for a fresh attempt to restart fluoridation after the irritating 28 year delay, these surveys provide the original data that the Tooth Police use to terrify them and the public. And what quickly became obvious was that there's definitely some dodgy business going on here. That's when I started to feel really REALLY alarmed.

These National Surveys are a sham, not worth the computer memory that they are stored on (the paper-less office has arrived at the UKCAF HQ!). Half of the data in the 2012 survey on 5 year olds, for example, have to be junked before one even starts! The whole slant of the analysis is grotesquely inappropriate, and Certain Things are carefully not being commented upon. Not quite as many as are missing from PHE’s Report that has been derived from it, but there’s a limit to how much space I can devote to this subject here. If I were to dissect the entire database you’d be exhausted long before I got to the end.

Checking out the original data

But fortunately, electronic storage of that vast collection of basic data made it easy to play around with the original number. I wanted to find out just what they had ‘forgotten’ to put into their huge and intimidating (but not to me!) Tables. And what I found is, that most of what they are trying to tell us is a big fat lie. Yes, really. If this is the quality of ‘evidence’ on which our future public health policy is to be founded, then we really are in for a rough ride to the graveyard

It appears that we now have a public health policy on water fluoridation that is founded on seriously biased and mainly worthless data held a major national database on health that is not fit for purpose. And the inventors of this policy have used a grubby grab-bag of cherry-picking, obfuscation and dodgy statistical techniques to try to prop up their ridiculous fluoridation policy, purely to make it look like the greatest public health intervention ever discovered.

A real-life Major Incident in the public health sector.

All this deception and malpractice has only one aim - to force the public to take its medicine, like it or not. This is despite the fact that this blatant mass medication is actually in violation of International, European and English law (see David Shaw's deconstruction of the legitimacy of fluoridation, when he notes that the continuation of fluoridation is only possible by relying on the 'legal fiction' - the lie - that' it's not a medicine.)

Your teeth in their hands?

So ask yourself, is it really prudent to trust this stupid, politically motivated Super-QANGO to protect our kids’ health and safety, if it grabs at any evidence, no matter how dodgy and potentially dangerous, to dance to its Master’s tune?

We’re told that the National Health Service is in crisis, with ‘Major Incidents’ being declared by hospitals across the country. Well, administering a medicine is absolutely not within the authority of PHE. Yes, fluoridation may indeed be included as part of a public health strategy. But actually dosing patients - all of us - without consent and in defiance of medicinal law is a violation of both medicinal and human rights law. A lot of lawyers and insurers involved with both Councils and the public are finding this a very interesting development.

Public health and medical treatment - not at all the same thing

Prescribing medicines to people is solely the responsibility of medical people, not dental public health rogues and snake-oil salesmen. That means that it falls under the responsibility - and liability - of our hard-pressed NHS. But no-one is above the law, not even the NHS - if fluoridation is illegal, then prescribing it is also prohibited. Ignoring that simple fact is medical malpractice.

I believe that this is indeed a real Major Incident - a Major Emergency, in fact. But this is not one caused by poor management and lack of finance. It's the result of outright fraud and deliberate deception, involving medical and scientific fraud on an almost unprecedented level and scale. If we continue to allow a small band of incompetents and charlatans to dictate medicinal policy, especially to our children, and use whatever misleading evidence comes to hand to get their way, then where next in this green and polluted land?

Now this is what I call a REAL Major Incident!
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Sources for further reading

The opening quote on torturing data is by Hal Varian in his Richard Ely Lecture, "Computer Mediated Transactions", http://www.aeaweb.org/articles.php?doi=10.1257/aer.100.2.1),

Martin B (1999) Suppression of dissent in science. In Research in Social Problems and Public Policy, Volume 7, edited by William R. Freudenburg and Ted I. K. Youn (Stamford, CT: JAI Press, 1999), pp. 105-135. http://www.bmartin.cc/pubs/99rsppp.pdf

'From Hull and Hell and Halifax good Lord deliver us!' see Malcolm Bull's Calderdale Companion ( http://freepages.history.rootsweb.ancestry.com/~calderdalecompanion/mmh235.html), and Wikipedia on the Halfax Gibbet. ( http://en.wikipedia.org/wiki/Halifax_Gibbet )

Ioannidis JPA (2005) Why Most Published Research Findings Are False. PLoS Med 2(8): e124. doi: 10.1371/journal.pmed.0020124 http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124

Daniele Fanelli (2009) How Many Scientists Fabricate and Falsify Research? A Systematic Review and Meta-Analysis of Survey Data. PLoS ONE. 2009; 4(5): e5738. Published online May 29, 2009. doi: 10.1371/journal.pone.0005738. PMCID: PMC2685008
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0005738#pone-0005738-g006

Links to the National Dental Health Epidemiological Surveys are available at http://www.nwph.net/dentalhealth/

Shaw D (2012) Weeping and wailing and gnashing of teeth: The legal fiction of water fluoridation. Medical Law International 12(1) 11?