Ex-CDC Oral Health Director Bill Maas: “Dental Fluorosis Is Beautiful.” 10-17-2012

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1998 till he joined the Pew Charitable Trust a short while ago, Bill Maas was the director of the Oral Health Division at the CDC, the only division that speaks on fluoridation at the CDC. The CDC, in turn, is also the only federal agency that actively promotes fluoridation. The FDA has never regulated fluoride for ingestion either as a prescription drug or when added to the public water supply. Its official position is that fluoride is an “unapproved drug.” The EPA does not regulate additives to water only contaminants. However, were it to do its job honestly and determine a science-based maximum contaminant level goal (MCLG) for fluoride in water – as the NRC panel recommended that it did in 2006 – it would scupper the fluoridation program, once and for all. A safe MCLG would have to be set well below 1 ppm. However, the EPA has dragged its feet for over six years, allowing its science to remain subservient to Department of Health and Human Services (DHHS) policy of continuing to support the practice of water fluoridation. Thus since 1986 the EPA water division has maintained the preposterous notion that the most sensitive end point to fluoride’s toxicity is crippling skeletal fluorosis. Other than die-hard fluoridation promoters there is not one genuine fluoride researcher that I have ever met who would support such a position. This is the law of the land but it is neither science-based nor represents honest or honorable regulation.  Thus with none of the other federal agencies prepared to act as honest broker on this practice, it has left the CDC’s Oral Health Division free reign to run the show (in tandem with the ADA) and to do so not with genuine science but with PR puffery.

And the chief of this puffery is Bill Maas, as you will see from his presentation. When you watch his presentation ask yourselves:

1) Is he a true believer in water fluoridation? I would say probably yes, but his job has been and continues to depend on not asking too many questions about the practice.

2) What science does he offer to support his position? There is very little science offered in his presentation. He simply parrots a belief system that started at dental school and persisted through dental practice and service to the US Public Health Service and thence to directorship of the CDC’s Oral Health Division. It appears to me that in the past he simply obeyed orders when he was director of the Oral Health Division and now appears to be a token spokesperson wheeled out by the Public Relations outfit hired by the Pew Charitable Trust, which has embarrassingly taken on the job of promoting this practice around the U.S. In other words he is playing the role that Michael Jordan once played for Nike shoes. But at least Michael Jordan had some talent.

3) What qualifications does he have? Bill Maas has a DDS and an MPH. Neither of these give him the expertise to talk about the safety of water fluoridation. To the best of my knowledge he has no specific training in toxicology or special training in many of the tissues that fluoride might adversely affect. Yet he states that fluoridation is “absolutely safe.” Bill Maas provides a very strong argument for getting dentistry back into the dental office and out of the public water supply.

4) How can he categorically state that fluoridation is safe? Maas does admit that fluoride can damage teeth but describes mild dental fluorosis as acceptable and at one point even that it is “beautiful.”  Mild dental fluorosis affects up to 50% of the tooth surface, and Dean (the father of fluoridation) stated before the US Congress that “mild” dental fluorosis was not an acceptable trade off for fighting tooth decay. One of the commissioners took huge exception with Maas forcing what amounts to an opinion on the American people. More seriously he was asked whether it was reasonable to assume that when fluoride was causing damage to the growing tooth cells and causing dental fluorosis that it was not causing any harm to any other tissue.

5) What are his claims of safety based upon? He provides no evidence that his safety claims are based on any primary literature he has read – because he cites none. Surprisingly, instead of first-hand science he cites the NRC review from 1993 – while downplaying the damning review by the same agency in 2006. Indeed, Bill Maas was head of Oral Health Division when the NRC report was issued in 2006, and six days after its publication this statement appeared on its web page:

 “The findings of the NRC report are consistent with CDC’s assessment that water is safe and healthy at the levels used for water fluoridation (0.7–1.2 mg/L).

Such a statement indicates that neither Maas nor his staff, who drafted this statement, know the difference between concentration and dose (see the harm identified at 1.9 ppm discussed below)! If Maas, or any of his staff at the CDC, had actually read the NRC report they would have found that in Chapter 2 of the NRC review, an exposure analysis indicated that there were subsets of the population, including bottle-fed infants, that were exceeding EPA’s safe reference dose (the IRIS level) for fluoride.

6) Why does he dismiss all health concerns as being based on “misinformation” on the web?  He doesn’t show that NRC report gives fluoridation a clean bill of health – nor could he because it doesn’t. In fact this is what the chairman of the NRC review panel, Professor John Doull, said about their findings in an interview he gave for a piece in the Scientific American in January of 2008,

What the committee found is that we’ve gone with the status quo regarding fluoride for many years—for too long really—and now we need to take a fresh look . . . In the scientific community people tend to think this is settled. I mean, when the U.S. surgeon general comes out and says this is one of the top 10 greatest achievements of the 20th century, that’s a hard hurdle to get over. But when we looked at the studies that have been done, we found that many of these questions are unsettled and we have much less information than we should, considering how long this [fluoridation] has been going on.

Instead of considering the merits of any of the many health concerns we and others have documented, Maas dismisses all of these as springing from “misinformation” on fluoride websites. Unfortunately, he never specifies any fluoride website, which is supposed to be “misinforming” the public. Had he specified the largest and most important website – i.e. the website of the Fluoride Action Network, www.FluorideALERT.org – then I would be delighted to challenge him to produce one piece of misinformation on our huge site. If he was referring to minor websites, then what is the relevance of his comment?

Maas never mentions the Harvard meta-analysis on the 27 studies that have shown a lowering of IQ associated with a fairly modest exposure to fluoride. For example, one IQ study found a threshold for lowering IQ at 1.9 ppm. This threshold offers no adequate margin for safety sufficient to protect all children drinking uncontrolled quantities of water in the range 0.7 to 1.2 ppm as well as getting fluoride from many other sources sufficient to give 41% of American adolescents dental fluorosis, based on CDC’s own data. Maas can hardly claim that the Harvard analysis is a figment of any webmaster’s imagination!

It is FAN that is providing the science on this issue to the public and has for many years. It is FAN that has had translated many of the IQ studies from the original Chinese. It is FAN that has provided a comprehensive review of all the literature on this issue, including cellular studies, animal studies, fetal studies, IQ studies and behavioral studies in children and adults.  The weight of evidence that fluoride is a neurotoxin is overwhelming.  You can read this for yourself – and so could Bill Maas – on our health database. But he doesn’t give any indication whatsoever that he has actually looked at the primary literature on fluoride’s role as a neurotoxin – or any other harm it may cause– and simply dismisses all the red flags being waved as “misinformation.” How convenient. How sloppy.

But it is not FAN that is misinforming the public. It is the CDC, the ADA and the Pew Charitable Trust both via their spokespersons and via their web pages. It is Bill Maas who deserves the label chief misinformer on fluoridation not Paul Connett. It is he who is keeping essential information away from the public and particularly parents who bottle-feed their babies using fluoridated tap water. Sadly, what Maas, the ADA and the Pew Charitable Trust can’t hide they spin.

This commentary is already gone on longer than I expected. FAN will be sending out another bulletin going into more detail on Maas’s misinformation and misrepresentation on several issues he presented to the Commissioners.

Another meeting in Wichita

At another meeting in Wichita, Bill Maas was asked by a citizen if he would be willing to come back and debate me later in the month (October). He declined, claiming that I was a brilliant debater and he wasn’t. I guess I should have been flattered, but then he added that I was the chief misinformer on fluoridation. Forgive me if I was upset by such a response. If he doesn’t have the guts to debate me – or any opponent of fluoridation for that matter– when he is the leading spokesperson for this practice, then he shouldn’t attack me when I am not around to respond. Moreover, if I am the leader in misinformation on this subject as he claims, I should be an easy person to beat in a debate. He would merely have had to list all the misinformation for which I am supposed to be guilty of distributing. He has many places to look for this misinformation (if it existed) since for 16 years I have not been reluctant to articulate and document my concerns. He could have started with the book I co-authored, The Case Against Fluoride (Connett, Beck and Micklem. Chelsea Green, 2010). Here every argument is documented in 80 pages of references to the primary literature. Then there is the health database on our website, which although it was largely prepared by my son Michael, I take responsibility for the accuracy therein. Then there is the testimony I gave before the National Research Council panel in October, 2003. Ironically, I gave my 45-minute invited testimony immediately after Bill Maas gave his. I will leave it to readers of the NRC (2006) review to determine which of our two presentations proved to be more telling.

Even Maas’s proffered evidence of fluoridation’s benefits are misleading. He claims that fluoridation reduces tooth decay by 25%. This number is based upon the survey of 39,000 children in the US conducted by the National Institute of Dental Research (NIDR) in 1986-7 and published by Brunelle and Carlos (1990). But reporting this as a relative saving and as a percentage is highly misleading. The 25% saving actually amounts to an absolute saving of less than one tooth surface out of the over 100 tooth surfaces in a child’s mouth. Reported this way it does not sound impressive at all. However, even worse is that the NIDR authors did not demonstrate that even this meager saving was statistically significant and recently Dr. Kathleen Thiessen, one of the authors of the NRC review, showed that it wasn’t.


When you get to meet fluoridation promoters like Bill Maas upfront and close, either in person or on video, they are not very impressive. I have had this opportunity in several countries (e.g. debating Professor Michael Lennon, chairman of the British Fluoridation Society on the Isle of Man; meeting and listening to Dr. Peter Cooney, the chief dental officer for Canada on several occasions; ditto the chief dental officer for the UK; ditto Dr. Joe Mullen and other promoters of fluoridation in Ireland and Dr. Robert Hall, chief medical officer of Victoria, Australia). Like Maas they offer little in the way of convincing scientific evidence to support their claims for either the safety or effectiveness of water fluoridation, merely endless lists of endorsements and citations of self-serving reviews by panels hand-picked by pro-fluoridation governments. As far as science is concerned they have feet of clay. It is all puffery, which they get away with because they have the power of being the front men for a policy backed by their respective governments.

Because of the influence of the U.S. in this matter, Bill Maas, must be fluoridation’s puffer-in-chief. Please let me know what you think.

Paul Connett, PhD,

Director of the Fluoride Action Network,

Co-author of The Case Against Fluoride

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