Preventative Medicine and Science

Don’t worry, this is not another article about the H1N1 vaccine. I admit though that the recent misinformation being spread about the vaccine is what gave me the idea I’m going to discuss. It’s mainly an observation that the areas of medicine that are most often attacked are forms of preventative medicine. While normally this wouldn’t be very interesting and would just be a curiosity, but I think I may be on to something due to the fact that the people launching these attacks will often, in other discussions, claim that “Western Medicine” (a pejorative term for scientific medicine) only seeks to treat illnesses, and don’t care about the root causes or prevention. I made this same observation on my podcast almost exactly a year ago. I noted that a couple of the biggest modern medical interventions that cause controversy were vaccines and water fluoridation (a topic so far largely ignored by the skeptical community).

Vaccines
Arguably, vaccines have been the most successful form of preventative medicine ever devised. Since the invention of the smallpox vaccine in the late 1700s by Edward Jennings, vaccines are considered by experts to have saved more lives than any other medical intervention. Even if we just look at smallpox, its eradication in the mid-part of the past century must have saved millions of lives. If we consider future generations, the number of lives saved approaches infinite (wrap your head around that). Vaccines work by exposing a person’s immune system to a disease in order to provoke an immune response. Modern vaccines do this by using dead or inactive forms of the pathogen so as not to make the patient sick. When the immune system is exposed to the disease pathogen, it begins to produce antibodies designed to attack that particular disease. Therefore, when the person then comes into contact with the disease in the wild, the body is ready to fight off the disease before any major damage can occur. Vaccines are the textbook example of scientific medicine producing an effective treatment that prevents illness.
 
Ever since vaccines were first introduced, it has had its fervent opponents. Some feared getting the illness from the vaccine it was designed to prevent (and that fear still exists), some disagreed with ethical policy of forced vaccinations, and some people were against vaccines because they believed that disease was God’s way of punishing sinners. Reasons for opposing vaccines have come and gone, but the numbers of opponents are ironically higher now than ever before (or so it seems) despite the efficacy and safety being better today than ever before.
 
If the opponents of scientific medicine were correct in their accusations that doctors what to keep people sick to earn profit from treatments, then we would still be treating people for smallpox and polio. If it weren’t for the anti-vaccine movement’s slander against science, we could have probably said goodbye to other vaccine preventable diseases like the measles by now. It cannot be said enough times: Fear and misinformation being spread about vaccines costs lives, perhaps an infinite number of lives.
 
Fluoride

If you think that people who are anti-vaccine are easily worked into a frenzy, I dare you to debate an anti-fluoridite (is that a word?). Fluoride is a naturally occurring chemical that was found to prevent tooth decay (i.e. cavities). It was discovered at the turn of the last century by Dr. Frederick S. McKay. He was a dentist in Colorado Springs and had noticed a strange colouration in the teeth of young people. Despite the aesthetic problems of their teeth, the children had a surprisingly low rate of cavities. It began to be added to the municipal water supply of cities starting in the 1940s. It readily became apparent that it prevented much tooth decay prompting its inclusion into other products such as tooth paste, milk, and salt. It is also used regularly in dentist offices to strengthen teeth during regular cleanings. The Center for Disease Control (the CDC) in the US considers water fluoridation to be one of the “top 10 public health achievements of the 20th century.” Water fluoridation is estimated to reduce tooth decay by as much as 40%. It is also important to consider that water fluoridation helps everyone, even people who cannot afford proper dental care. Water fluoridation is seen as one of the cheapest ways to improve the health of the public (only $0.92 per person per year). On top of that, it’s extremely safe. It’s only major side effect is a slight discolouration of the teeth if too much is consumed (don’t worry, average consumption of fluoride isn’t anywhere close enough to cause this and you have to be under the age of 8 to be effected). There have been cases of people getting sick, from over exposure to fluoride, but none of these cases were due to municipal water fluoridation, it is usually caused by dangerously high levels of naturally occurring fluoride in local drinking water. Water fluoridation has been more common in North America than Europe. European tooth decay rates only began to approach that of American’s in the 1970s, when fluoride became common in tooth paste there. 
 

In recent years tooth decay has been on the rise. Some theorize this is in part due to the increased popularity of bottled water, which often is not fluoridated. Filtered water will also often be missing out on fluoride. Don’t buy into the hype of bottled water, drink raw tap water for the strongest teeth!

Just like with vaccines, opponents of water fluoridation appeared from the start. Their complaints were very similar to that of the anti-vaccinationists. Their problems with fluoridation often came down to the ethical dilemma of public good versus individual liberty. Unfortunately, being opposed to public health measures on ethical stance alone isn’t enough for some people, they have to spread misinformation and fear too. Feel free to search google for information on ‘fluoride safety‘, after the first 2-3 informative links from organizations like the CDC, you’ll begin to discover the barrage of non-sense from the anti-fluoridation crowd. It’s a near miracle that the Wikipedia article about fluoride is as scientific as it is. Using Google to find valid information about water fluoridation is nearly impossible.

The amount of digital ink needed to debunk all their claims wouldn’t just require a blog article, but an entire blog. When it comes to the health of your teeth, talk to your dentist, don’t trust information from some random web site (note: this site is not random). 

Conclusion 
The claim that mainstream medicine only cares about treating illnesses and not preventing them is clearly a straw man. But why have these forms of treatments become such targets? My first guess is that it is due to their nature as public health measures. It is a common, and often worthwhile, trait to be skeptical of authority. When the government says to stick a needle in your arm or put a chemical in your drinking water, you can fairly ask if it’s in your best interest. Luckily, we don’t need to take the government on their word, we can go to the science and it turns out that the government, at least in this case, is acting in our best interest. I also think that denial of preventable treatments may come from the fact that it isn’t obvious to people how effective these interventions are. I often hear that it’s ok to go to a doctor to fix a broken arm, but not ok to go for a vaccine. With a broken arm, it is obvious to the patient the benefit they’re receiving. With a vaccine, the benefit is much less obvious, and requires a basic understanding of science and statistics to appreciate. I for one appreciate my doctor and all the benefits that scientific medicine has brought me and society.

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  • Jonathan Abrams

    Jonathan Abrams is the latest founder and president of the Ottawa Skeptics. He organizes local events, makes media appearances as the token skeptic, and is one of the website maintainers. He is the host of the skepticism podcast The Reality Check. When he’s not thinking about science and skepticism, he’s working as a computer engineer, playing pinball, or doing the dishes.