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Fluoridation does not affect the appearance, taste or smell of drinking water.[1]
Water fluoridation is the controlled adjustment of fluoride to a public water supply to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride.[2] Fluoridated water operates on tooth surfaces: in the mouth, it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities.[3] Typically a fluoridated compound is added to drinking water, a process that in the U.S. costs an average of about $1.11 per person-year.[2][4] Defluoridation is needed when the naturally occurring fluoride level exceeds recommended limits.[5] In 2011 the World Health Organization suggested a level of fluoride from 0.5 to 1.5 mg/L (milligrams per litre), depending on climate, local environment, and other sources of fluoride.[6] Bottled water typically has unknown fluoride levels.[7]
Tooth decay remains a major public health concern in most industrialized countries, affecting 60–90% of schoolchildren and the vast majority of adults.[8] Water fluoridation reduces cavities in children, while efficacy in adults is less clear.[9][10] A Cochrane review estimates a reduction in cavities when water fluoridation was used by children who had no access to other sources of fluoride to be 35% in baby teeth and 26% in permanent teeth.[9] However this was based on older studies which failed to control for numerous variables, such as increasing sugar consumption as well as other dental strategies.[9] Most European countries have experienced substantial declines in tooth decay, though milk and salt fluoridation is widespread in lieu of water fluoridation.[11] Recent studies suggest that water fluoridation, particularly in industrialized nations, may be unnecessary because topical fluorides (such as in toothpaste) are widely used, and caries rates have become low.[3]
Although fluoridation can cause dental fluorosis, which can alter the appearance of developing teeth or enamel fluorosis,[3] the differences are mild and usually not an aesthetic or public health concern.[12] There is no clear evidence of other adverse effects from water fluoridation.[13] Fluoride's effects depend on the total daily intake of fluoride from all sources. Drinking water is typically the largest source;[14] other methods of fluoride therapy include fluoridation of toothpaste, salt, and milk.[15] The views on the most efficient method for community prevention of tooth decay are mixed. The Australian government states that water fluoridation is the most effective way to achieve fluoride exposure that is community-wide.[12] The World Health Organization reports that water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk,[8] while the European Commission finds no benefit to water fluoridation compared with topical use.[16]
Public water fluoridation was first practiced in the U.S.[17] As of 2012, 25 countries have artificial water fluoridation to varying degrees, 11 of them have more than 50% of their population drinking fluoridated water. A further 28 countries have water that is naturally fluoridated, though in many of them the fluoride is above the optimal level.[18] As of 2012, about 435 million people worldwide received water fluoridated at the recommended level (i.e., about 5.4% of the global population).[18] About 214 million of them living in the United States.[19] Major health organizations such as the World Health Organization and FDI World Dental Federation supported water fluoridation as safe and effective.[20] The Centers for Disease Control and Prevention lists water fluoridation as one of the ten great public health achievements of the 20th century in the U.S.[21] Despite this, the practice is controversial as a public health measure. Some countries and communities have discontinued fluoridation, while others have expanded it.[10][22] Opponents of the practice argue that neither the benefits nor the risks have been studied adequately, and debate the conflict between what might be considered mass medication and individual liberties.[22][23]
2.1 Recommendations
2.2 Occurrences
3.1 Effectiveness
3.2 Fluorosis
3.3 Safety
4 Mechanism
5 Alternatives
6 Worldwide prevalence
8 Economics
A cavity starts in a tooth's outer enamel and spreads to the dentin and pulp inside.
The goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies.[2] Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide.[24] Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society,[25] and it greatly affects the quality of life of children, particularly those of low socioeconomic status.[24] In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there because of changing diet and inadequate fluoride exposure.[8] In the U.S., minorities and the poor both have higher rates of decayed and missing teeth,[26] and their children have less dental care.[27] Once a cavity occurs, the tooth's fate is that of repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years.[28] Oral disease is the fourth most expensive disease to treat.[29] The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of congenital hypothyroidism and goiter.[30]
The goal of water fluoridation is to prevent a chronic disease whose burdens particularly fall on children and the poor.[24] Another of the goals was to bridge inequalities in dental health and dental care.[31] Some studies suggest that fluoridation reduces oral health inequalities between the rich and poor, but the evidence is limited.[3] There is anecdotal but not scientific evidence that fluoride allows more time for dental treatment by slowing the progression of tooth decay, and that it simplifies treatment by causing most cavities to occur in pits and fissures of teeth.[32] Other reviews have found not enough evidence to determine if water fluoridation reduces oral-health social disparities.[9]
Health and dental organizations worldwide have endorsed its safety and effectiveness.[3] Its use began in 1945, following studies of children in a region where higher levels of fluoride occur naturally in the water.[33] Further research showed that moderate fluoridation prevents tooth decay.[34]
Fluoride monitor (at left) in a community water tower pumphouse, Minnesota, 1987
Fluoridation does not affect the appearance, taste, or smell of drinking water.[1] It is normally accomplished by adding one of three compounds to the water: sodium fluoride, fluorosilicic acid, or sodium fluorosilicate.
Sodium fluoride (NaF) was the first compound used and is the reference standard.[35] It is a white, odorless powder or crystal; the crystalline form is preferred if manual handling is used, as it minimizes dust.[36] It is more expensive than the other compounds, but is easily handled and is usually used by smaller utility companies.[37] It is toxic in gram quantities by ingestion or inhalation.[38]
Fluorosilicic acid (H2SiF6) is the most commonly used additive for water fluoridation in the United States.[39] It is an inexpensive liquid by-product of phosphate fertilizer manufacture.[35] It comes in varying strengths, typically 23–25%; because it contains so much water, shipping can be expensive.[36] It is also known as hexafluorosilicic, hexafluosilicic, hydrofluosilicic, and silicofluoric acid.[35]
Sodium fluorosilicate (Na2SiF6) is the sodium salt of fluorosilicic acid. It is a powder or very fine crystal that is easier to ship than fluorosilicic acid. It is also known as sodium silicofluoride.[36]
These compounds were chosen for their solubility, safety, availability, and low cost.[35] A 1992 census found that, for U.S. public water supply systems reporting the type of compound used, 63% of the population received water fluoridated with fluorosilicic acid, 28% with sodium fluorosilicate, and 9% with sodium fluoride.[40]
The Centers for Disease Control and Prevention developed recommendations for water fluoridation that specify requirements for personnel, reporting, training, inspection, monitoring, surveillance, and actions in case of overfeed, along with technical requirements for each major compound used.[41]
Although fluoride was once considered an essential nutrient, the U.S. National Research Council has since removed this designation due to the lack of studies showing it is essential for human growth, though still considering fluoride a "beneficial element" due to its positive impact on oral health.[42] The European Food Safety Authority's Panel on Dietetic Products, Nutrition and Allergies (NDA) considers fluoride not to be an essential nutrient, yet, due to the beneficial effects of dietary fluoride on prevention of dental caries they have defined an Adequate Intake (AI) value for it. The AI of fluoride from all sources (including non-dietary sources) is 0.05 mg/kg body weight per day for both children and adults, including pregnant and lactating women.[43]
In 2011, the U.S. Department of Health and Human Services (HHS) and the U.S. Environmental Protection Agency (EPA) lowered the recommended level of fluoride to 0.7 mg/L.[44] In 2015, the U.S. Food and Drug Administration (FDA), based on the recommendation of the U.S. Public Health Service (PHS) for fluoridation of community water systems, recommended that bottled water manufacturers limit fluoride in bottled water to no more than 0.7 milligrams per liter (mg/L)(milligrams per liter, equivalent to parts per million).[45]
Previous recommendations were based on evaluations from 1962, when the U.S. specified the optimal level of fluoride to range from 0.7 to 1.2 mg/L (milligrams per liter, equivalent to parts per million), depending on the average maximum daily air temperature; the optimal level is lower in warmer climates, where people drink more water, and is higher in cooler climates.[46]
These standards are not appropriate for all parts of the world, where fluoride levels might be excessive and fluoride should be removed from water, and is based on assumptions that have become obsolete with the rise of air conditioning and increased use of soft drinks, processed food, fluoridated toothpaste, and other sources of fluorides.[6] In 2011 the World Health Organization stated that 1.5 mg/L should be an absolute upper bound and that 0.5 mg/L may be an appropriate lower limit.[6] A 2007 Australian systematic review recommended a range from 0.6 to 1.1 mg/L.[12]
Geographical areas associated with groundwater having over 1.5 mg/L of naturally occurring fluoride, which is above recommended levels.[12]
Detail of southern Arizona. Areas in darker blues have groundwater with over 2 mg/L of naturally occurring fluoride.
Fluoride naturally occurring in water can be above, at, or below recommended levels. Rivers and lakes generally contain fluoride levels less than 0.5 mg/L, but groundwater, particularly in volcanic or mountainous areas, can contain as much as 50 mg/L.[14] Higher concentrations of fluorine are found in alkaline volcanic, hydrothermal, sedimentary, and other rocks derived from highly evolved magmas and hydrothermal solutions, and this fluorine dissolves into nearby water as fluoride. In most drinking waters, over 95% of total fluoride is the F− ion, with the magnesium–fluoride complex (MgF+) being the next most common. Because fluoride levels in water are usually controlled by the solubility of fluorite (CaF2), high natural fluoride levels are associated with calcium-deficient, alkaline, and soft waters.[47] Defluoridation is needed when the naturally occurring fluoride level exceeds recommended limits. It can be accomplished by percolating water through granular beds of activated alumina, bone meal, bone char, or tricalcium phosphate; by coagulation with alum; or by precipitation with lime.[5]
Pitcher or faucet-mounted water filters do not alter fluoride content; the more-expensive reverse osmosis filters remove 65–95% of fluoride, and distillation removes all fluoride.[7] Some bottled waters contain undeclared fluoride, which can be present naturally in source waters, or if water is sourced from a public supply which has been fluoridated.[48] The FDA states that bottled water products labeled as de-ionized, purified, demineralized, or distilled have been treated in such a way that they contain no or only trace amounts of fluoride, unless they specifically list fluoride as an added ingredient.[48]
Existing evidence suggests that water fluoridation reduces tooth decay. Consistent evidence also suggests that it causes dental fluorosis, most of which is mild and not usually of aesthetic concern.[9][12] No clear evidence of other adverse effects exists, though almost all research thereof has been of poor quality.[13]
Reviews have shown that water fluoridation reduces cavities in children.[9][16][49] A conclusion for the efficacy in adults is less clear with some reviews finding benefit and others not.[9][49] Studies in the U.S. in the 1950s and 1960s showed that water fluoridation reduced childhood cavities by fifty to sixty percent, while studies in 1989 and 1990 showed lower reductions (40% and 18% respectively), likely due to increasing use of fluoride from other sources, notably toothpaste, and also the 'halo effect' of food and drink that is made in fluoridated areas and consumed in unfluoridated ones.[2]
A 2000 UK systematic review (York) found that water fluoridation was associated with a decreased proportion of children with cavities of 15% and with a decrease in decayed, missing, and filled primary teeth (average decreases was 2.25 teeth). The review found that the evidence was of moderate quality: few studies attempted to reduce observer bias, control for confounding factors, report variance measures, or use appropriate analysis. Although no major differences between natural and artificial fluoridation were apparent, the evidence was inadequate for a conclusion about any differences.[13] A 2007 Australian systematic review used the same inclusion criteria as York's, plus one additional study. This did not affect the York conclusions.[50] A 2011 European Commission systematic review based its efficacy on York's review conclusion.[10] A 2015 Cochrane systematic review estimated a reduction in cavities when water fluoridation was used by children who had no access to other sources of fluoride to be 35% in baby teeth and 26% in permanent teeth.[9] The evidence was of poor quality.[9]
Fluoride may also prevent cavities in adults of all ages. A 2007 meta-analysis by CDC researchers found that water fluoridation prevented an estimated 27% of cavities in adults, about the same fraction as prevented by exposure to any delivery method of fluoride (29% average).[51] A 2011 European Commission review found that the benefits of water fluoridation for adult in terms of reductions in decay are limited.[16] A 2015 Cochrane review found no conclusive research regarding the effectiveness of water fluoridation in adults.[9] A 2016 review found variable quality evidence that, overall, stopping of community water fluoridation programs was typically followed by an increase in cavities.[52]
Most countries in Europe have experienced substantial declines in cavities without the use of water fluoridation due to the introduction of fluoridated toothpaste and the large use of other fluoride-containing products, including mouthrinse, dietary supplements, and professionally applied or prescribed gel, foam, or varnish.[3] For example, in Finland and Germany, tooth decay rates remained stable or continued to decline after water fluoridation stopped in communities with widespread fluoride exposure from other sources. Fluoridation is however still clearly necessary in the U.S. because unlike most European countries, the U.S. does not have school-based dental care, many children do not visit a dentist regularly, and for many U.S. children water fluoridation is the prime source of exposure to fluoride.[31] The effectiveness of water fluoridation can vary according to circumstances such as whether preventive dental care is free to all children.[53]
A mild case of dental fluorosis, visible as white streaks on the subject's upper right central incisor.
Fluoride's adverse effects depend on total fluoride dosage from all sources. At the commonly recommended dosage, the only clear adverse effect is dental fluorosis, which can alter the appearance of children's teeth during tooth development; this is mostly mild and is unlikely to represent any real effect on aesthetic appearance or on public health.[12] In April 2015, recommended fluoride levels in the United States were changed to 0.7 ppm from 0.7–1.2 ppm to reduce the risk of dental fluorosis.[54] The 2015 Cochrane review estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12%.[9] This increases to 40% when considering fluorosis of any level not of aesthetic concern.[9] In the US mild or very mild dental fluorosis has been reported in 20% of the population, moderate fluorosis in 2% and severe fluorosis in less than 1%.[54]
The critical period of exposure is between ages one and four years, with the risk ending around age eight. Fluorosis can be prevented by monitoring all sources of fluoride, with fluoridated water directly or indirectly responsible for an estimated 40% of risk and other sources, notably toothpaste, responsible for the remaining 60%.[55] Compared to water naturally fluoridated at 0.4 mg/L, fluoridation to 1 mg/L is estimated to cause additional fluorosis in one of every 6 people (95% CI 4–21 people), and to cause additional fluorosis of aesthetic concern in one of every 22 people (95% CI 13.6–∞ people). Here, aesthetic concern is a term used in a standardized scale based on what adolescents would find unacceptable, as measured by a 1996 study of British 14-year-olds.[13] In many industrialized countries the prevalence of fluorosis is increasing even in unfluoridated communities, mostly because of fluoride from swallowed toothpaste.[56] A 2009 systematic review indicated that fluorosis is associated with consumption of infant formula or of water added to reconstitute the formula, that the evidence was distorted by publication bias, and that the evidence that the formula's fluoride caused the fluorosis was weak.[57] In the U.S. the decline in tooth decay was accompanied by increased fluorosis in both fluoridated and unfluoridated communities; accordingly, fluoride has been reduced in various ways worldwide in infant formulas, children's toothpaste, water, and fluoride-supplement schedules.[32]
Fluoridation has little effect on risk of bone fracture (broken bones); it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation.[12] There is no clear association between fluoridation and cancer or deaths due to cancer, both for cancer in general and also specifically for bone cancer and osteosarcoma.[12][13] Other adverse effects lack sufficient evidence to reach a confident conclusion.[13]
Fluoride can occur naturally in water in concentrations well above recommended levels, which can have several long-term adverse effects, including severe dental fluorosis, skeletal fluorosis, and weakened bones; water utilities in the developed world reduce fluoride levels to regulated maximum levels in regions where natural levels are high, and the WHO and other groups work with countries and regions in the developing world with naturally excessive fluoride levels to achieve safe levels.[58] The World Health Organization recommends a guideline maximum fluoride value of 1.5 mg/L as a level at which fluorosis should be minimal.[59]
In rare cases improper implementation of water fluoridation can result in overfluoridation that causes outbreaks of acute fluoride poisoning, with symptoms that include nausea, vomiting, and diarrhea. Three such outbreaks were reported in the U.S. between 1991 and 1998, caused by fluoride concentrations as high as 220 mg/L; in the 1992 Alaska outbreak, 262 people became ill and one person died.[60] In 2010, approximately 60 gallons of fluoride were released into the water supply in Asheboro, North Carolina in 90 minutes—an amount that was intended to be released in a 24-hour period.[61]
Like other common water additives such as chlorine, hydrofluosilicic acid and sodium silicofluoride decrease pH and cause a small increase of corrosivity, but this problem is easily addressed by increasing the pH.[62] Although it has been hypothesized that hydrofluosilicic acid and sodium silicofluoride might increase human lead uptake from water, a 2006 statistical analysis did not support concerns that these chemicals cause higher blood lead concentrations in children.[63] Trace levels of arsenic and lead may be present in fluoride compounds added to water, but no credible evidence exists that their presence is of concern: concentrations are below measurement limits.[62]
The effect of water fluoridation on the natural environment has been investigated, and no adverse effects have been established. Issues studied have included fluoride concentrations in groundwater and downstream rivers; lawns, gardens, and plants; consumption of plants grown in fluoridated water; air emissions; and equipment noise.[62]
Fluoride exerts its major effect by interfering with the demineralization mechanism of tooth decay. Tooth decay is an infectious disease, the key feature of which is an increase within dental plaque of bacteria such as Streptococcus mutans and Lactobacillus. These produce organic acids when carbohydrates, especially sugar, are eaten.[64] When enough acid is produced to lower the pH below 5.5,[65] the acid dissolves carbonated hydroxyapatite, the main component of tooth enamel, in a process known as demineralization. After the sugar is gone, some of the mineral loss can be recovered—or remineralized—from ions dissolved in the saliva. Cavities result when the rate of demineralization exceeds the rate of remineralization, typically in a process that requires many months or years.[64]
Demineralization and remineralization of dental enamel in the presence of acid and fluoride in saliva and plaque fluid.[64]
All fluoridation methods, including water fluoridation, create low levels of fluoride ions in saliva and plaque fluid, thus exerting a topical or surface effect. A person living in an area with fluoridated water may experience rises of fluoride concentration in saliva to about 0.04 mg/L several times during a day.[3] Technically, this fluoride does not prevent cavities but rather controls the rate at which they develop.[66] When fluoride ions are present in plaque fluid along with dissolved hydroxyapatite, and the pH is higher than 4.5,[65] a fluorapatite-like remineralized veneer is formed over the remaining surface of the enamel; this veneer is much more acid-resistant than the original hydroxyapatite, and is formed more quickly than ordinary remineralized enamel would be.[64] The cavity-prevention effect of fluoride is mostly due to these surface effects, which occur during and after tooth eruption.[67] Although some systemic (whole-body) fluoride returns to the saliva via blood plasma, and to unerupted teeth via plasma or crypt fluid, there is little data to determine what percentages of fluoride's anticavity effect comes from these systemic mechanisms.[68] Also, although fluoride affects the physiology of dental bacteria,[69] its effect on bacterial growth does not seem to be relevant to cavity prevention.[70]
Fluoride's effects depend on the total daily intake of fluoride from all sources.[14] About 70–90% of ingested fluoride is absorbed into the blood, where it distributes throughout the body. In infants 80–90% of absorbed fluoride is retained, with the rest excreted, mostly via urine; in adults about 60% is retained. About 99% of retained fluoride is stored in bone, teeth, and other calcium-rich areas, where excess quantities can cause fluorosis.[58] Drinking water is typically the largest source of fluoride.[14] In many industrialized countries swallowed toothpaste is the main source of fluoride exposure in unfluoridated communities.[56] Other sources include dental products other than toothpaste; air pollution from fluoride-containing coal or from phosphate fertilizers; trona, used to tenderize meat in Tanzania; and tea leaves, particularly the tea bricks favored in parts of China. High fluoride levels have been found in other foods, including barley, cassava, corn, rice, taro, yams, and fish protein concentrate. The U.S. Institute of Medicine has established Dietary Reference Intakes for fluoride: Adequate Intake values range from 0.01 mg/day for infants aged 6 months or less, to 4 mg/day for men aged 19 years and up; and the Tolerable Upper Intake Level is 0.10 mg/kg/day for infants and children through age 8 years, and 10 mg/day thereafter.[71] A rough estimate is that an adult in a temperate climate consumes 0.6 mg/day of fluoride without fluoridation, and 2 mg/day with fluoridation. However, these values differ greatly among the world's regions: for example, in Sichuan, China the average daily fluoride intake is only 0.1 mg/day in drinking water but 8.9 mg/day in food and 0.7 mg/day directly from the air due to the use of high-fluoride soft coal for cooking and drying foodstuffs indoors.[14]
Fluoride toothpaste is effective against cavities. It is widely used, but less so among the poor.[15]
Fluoridated iodized salt sold in Germany
The views on the most effective method for community prevention of tooth decay are mixed. The Australian government review states that water fluoridation is the most effective means of achieving fluoride exposure that is community-wide.[12] The European Commission review states "No obvious advantage appears in favour of water fluoridation compared with topical prevention".[16] Other fluoride therapies are also effective in preventing tooth decay;[24] they include fluoride toothpaste, mouthwash, gel, and varnish,[72] and fluoridation of salt and milk.[15] Dental sealants are effective as well,[24] with estimates of prevented cavities ranging from 33% to 86%, depending on age of sealant and type of study.[72]
Fluoride toothpaste is the most widely used and rigorously evaluated fluoride treatment.[15] Its introduction is considered the main reason for the decline in tooth decay in industrialized countries,[3] and toothpaste appears to be the single common factor in countries where tooth decay has declined.[73] Toothpaste is the only realistic fluoride strategy in many low-income countries, where lack of infrastructure renders water or salt fluoridation infeasible.[74] It relies on individual and family behavior, and its use is less likely among lower economic classes;[15] in low-income countries it is unaffordable for the poor.[74] Fluoride toothpaste prevents about 25% of cavities in young permanent teeth, and its effectiveness is improved if higher concentrations of fluoride are used, or if the toothbrushing is supervised. Fluoride mouthwash and gel are about as effective as fluoride toothpaste; fluoride varnish prevents about 45% of cavities.[72] By comparison, brushing with a nonfluoride toothpaste has little effect on cavities.[56]
The effectiveness of salt fluoridation is about the same as that of water fluoridation, if most salt for human consumption is fluoridated. Fluoridated salt reaches the consumer in salt at home, in meals at school and at large kitchens, and in bread. For example, Jamaica has just one salt producer, but a complex public water supply; it started fluoridating all salt in 1987, achieving a decline in cavities. Universal salt fluoridation is also practiced in Colombia and the Swiss Canton of Vaud; in Germany fluoridated salt is widely used in households but unfluoridated salt is also available, giving consumers a choice. Concentrations of fluoride in salt range from 90 to 350 mg/kg, with studies suggesting an optimal concentration of around 250 mg/kg.[15]
Milk fluoridation is practiced by the Borrow Foundation in some parts of Bulgaria, Chile, Peru, Russia, Macedonia, Thailand and the UK. Depending on location, the fluoride is added to milk, to powdered milk, or to yogurt. For example, milk powder fluoridation is used in rural Chilean areas where water fluoridation is not technically feasible.[75] These programs are aimed at children, and have neither targeted nor been evaluated for adults.[15] A systematic review found low-quality evidence to support the practice, but also concluded that further studies were needed.[76]
Other public-health strategies to control tooth decay, such as education to change behavior and diet, have lacked impressive results.[32] Although fluoride is the only well-documented agent which controls the rate at which cavities develop, it has been suggested that adding calcium to the water would reduce cavities further.[77] Other agents to prevent tooth decay include antibacterials such as chlorhexidine and sugar substitutes such as xylitol.[72] Xylitol-sweetened chewing gum has been recommended as a supplement to fluoride and other conventional treatments if the gum is not too costly.[78] Two proposed approaches, bacteria replacement therapy (probiotics) and caries vaccine, would share water fluoridation's advantage of requiring only minimal patient compliance, but have not been proven safe and effective.[72] Other experimental approaches include fluoridated sugar, polyphenols, and casein phosphopeptide–amorphous calcium phosphate nanocomplexes.[79]
A 2007 Australian review concluded that water fluoridation is the most effective and socially the most equitable way to expose entire communities to fluoride's cavity-prevention effects.[12] A 2002 U.S. review estimated that sealants decreased cavities by about 60% overall, compared to about 18–50% for fluoride.[80] A 2007 Italian review suggested that water fluoridation may not be needed, particularly in the industrialized countries where cavities have become rare, and concluded that toothpaste and other topical fluoride are the best way to prevent cavities worldwide.[3] A 2004 World Health Organization review stated that water fluoridation, when it is culturally acceptable and technically feasible, has substantial advantages in preventing tooth decay, especially for subgroups at high risk.[8]
Worldwide prevalence
Main article: Fluoridation by country
Percentage of population receiving fluoridated water, including both artificial and natural fluoridation, as of 2012.[18]
As of November 2012, a total of about 378 million people worldwide received artificially fluoridated water. The majority of those were in the United States. About 40 million worldwide received water that was naturally fluoridated to recommended levels.[18]
Much of the early work on establishing the connection between fluoride and dental health was performed by scientists in the U.S. during the early 20th century, and the U.S. was the first country to implement public water fluoridation on a wide scale.[17] It has been introduced to varying degrees in many countries and territories outside the U.S., including Argentina, Australia, Brazil, Canada, Chile, Colombia, Hong Kong, Ireland, Israel, Korea, Malaysia, New Zealand, the Philippines, Serbia, Singapore, Spain, the UK, and Vietnam. In 2004, an estimated 13.7 million people in western Europe and 194 million in the U.S. received artificially fluoridated water.[18] In 2010, about 66% of the U.S. population was receiving fluoridated water.[81]
Naturally fluoridated water is used by approximately 4% of the world's population, in countries including Argentina, France, Gabon, Libya, Mexico, Senegal, Sri Lanka, Tanzania, the U.S., and Zimbabwe. In some locations, notably parts of Africa, China, and India, natural fluoridation exceeds recommended levels.[18]
Communities have discontinued water fluoridation in some countries, including Finland, Germany, Japan, the Netherlands, and Switzerland.[82] On 26 August 2014, Israel stopped mandating fluoridation, stating "Only some 1% of the water is used for drinking, while 99% of the water is intended for other uses (industry, agriculture, flushing toilets etc.). There is also scientific evidence that fluoride in large amounts can lead to damage to health. When fluoride is supplied via drinking water, there is no control regarding the amount of fluoride actually consumed, which could lead to excessive consumption. Supply of fluoridated water forces those who do not so wish to also consume water with added fluoride. This approach is therefore not accepted in most countries in the world."[83][84] This change was often motivated by political opposition to water fluoridation, but sometimes the need for water fluoridation was met by alternative strategies. The use of fluoride in its various forms is the foundation of tooth decay prevention throughout Europe; several countries have introduced fluoridated salt, with varying success: in Switzerland and Germany, fluoridated salt represents 65% to 70% of the domestic market, while in France the market share reached 60% in 1993 but dwindled to 14% in 2009; Spain, in 1986 the second West European country to introduce fluoridation of table salt, reported a market share in 2006 of only 10%. In three other West European countries, Greece, Austria and the Netherlands, the legal framework for production and marketing of fluoridated edible salt exists. At least six Central European countries (Hungary, the Czech and Slovak Republics, Croatia, Slovenia, Romania) have shown some interest in salt fluoridation; however, significant usage of approximately 35% was only achieved in the Czech Republic. The Slovak Republic had the equipment to treat salt by 2005; in the other four countries attempts to introduce fluoridated salt were not successful.[85][86]
See also: History of water supply and sanitation
1909 photograph by Frederick McKay of G.V. Black (left), Isaac Burton and F.Y. Wilson, studying the Colorado brown stain.[87]
The history of water fluoridation can be divided into three periods. The first (c. 1801–1933) was research into the cause of a form of mottled tooth enamel called the Colorado brown stain. The second (c. 1933–1945) focused on the relationship between fluoride concentrations, fluorosis, and tooth decay, and established that moderate levels of fluoride prevent cavities. The third period, from 1945 on, focused on adding fluoride to community water supplies.[34]
In the first half of the 19th century, investigators established that fluoride occurs with varying concentrations in teeth, bone, and drinking water. In the second half they speculated that fluoride would protect against tooth decay, proposed supplementing the diet with fluoride, and observed mottled enamel (now called severe dental fluorosis) without knowing the cause.[88] In 1874, the German public health officer Carl Wilhelm Eugen Erhardt recommended potassium fluoride supplements to preserve teeth.[89][90] In 1892 the British physician James Crichton-Browne noted in an address that fluoride's absence from diets had resulted in teeth that were "peculiarly liable to decay", and who proposed "the reintroduction into our diet ... of fluorine in some suitable natural form ... to fortify the teeth of the next generation".[91]
The foundation of water fluoridation in the U.S. was the research of the dentist Frederick McKay (1874–1959). McKay spent thirty years investigating the cause of what was then known as the Colorado brown stain, which produced mottled but also cavity-free teeth; with the help of G.V. Black and other researchers, he established that the cause was fluoride.[92] The first report of a statistical association between the stain and lack of tooth decay was made by UK dentist Norman Ainsworth in 1925. In 1931, an Alcoa chemist, H.V. Churchill, concerned about a possible link between aluminum and staining, analyzed water from several areas where the staining was common and found that fluoride was the common factor.[93]
H. Trendley Dean set out in 1931 to study fluoride's harm, but by 1950 had demonstrated the cavity-prevention effects of small amounts.[94]
In the 1930s and early 1940s, H. Trendley Dean and colleagues at the newly created U.S. National Institutes of Health published several epidemiological studies suggesting that a fluoride concentration of about 1 mg/L was associated with substantially fewer cavities in temperate climates, and that it increased fluorosis but only to a level that was of no medical or aesthetic concern.[95] Other studies found no other significant adverse effects even in areas with fluoride levels as high as 8 mg/L.[96] To test the hypothesis that adding fluoride would prevent cavities, Dean and his colleagues conducted a controlled experiment by fluoridating the water in Grand Rapids, Michigan, starting 25 January 1945. The results, published in 1950, showed significant reduction of cavities.[33][97] Significant reductions in tooth decay were also reported by important early studies outside the U.S., including the Brantford–Sarnia–Stratford study in Canada (1945–1962), the Tiel–Culemborg study in the Netherlands (1953–1969), the Hastings study in New Zealand (1954–1970), and the Department of Health study in the U.K. (1955–1960).[93] By present-day standards these and other pioneering studies were crude, but the large reductions in cavities convinced public health professionals of the benefits of fluoridation.[31]
Fluoridation became an official policy of the U.S. Public Health Service by 1951, and by 1960 water fluoridation had become widely used in the U.S., reaching about 50 million people.[96] By 2006, 69.2% of the U.S. population on public water systems were receiving fluoridated water, amounting to 61.5% of the total U.S. population; 3.0% of the population on public water systems were receiving naturally occurring fluoride.[98] In some other countries the pattern was similar. New Zealand, which led the world in per-capita sugar consumption and had the world's worst teeth, began fluoridation in 1953, and by 1968 fluoridation was used by 65% of the population served by a piped water supply.[99] Fluoridation was introduced into Brazil in 1953, was regulated by federal law starting in 1974, and by 2004 was used by 71% of the population.[100] In the Republic of Ireland, fluoridation was legislated in 1960, and after a constitutional challenge the two major cities of Dublin and Cork began it in 1964;[93] fluoridation became required for all sizeable public water systems and by 1996 reached 66% of the population.[18] In other locations, fluoridation was used and then discontinued: in Kuopio, Finland, fluoridation was used for decades but was discontinued because the school dental service provided significant fluoride programs and the cavity risk was low, and in Basel, Switzerland, it was replaced with fluoridated salt.[93]
McKay's work had established that fluorosis occurred before tooth eruption. Dean and his colleagues assumed that fluoride's protection against cavities was also pre-eruptive, and this incorrect assumption was accepted for years. By 2000, however, the topical effects of fluoride (in both water and toothpaste) were well understood, and it had become known that a constant low level of fluoride in the mouth works best to prevent cavities.[101]
Fluoridation costs an estimated $1.11 per person-year on the average (range: $0.26–$11.69; all costs in this paragraph are for the U.S.[2] and are in 2019 dollars, inflation-adjusted from earlier estimates[4]). Larger water systems have lower per capita cost, and the cost is also affected by the number of fluoride injection points in the water system, the type of feeder and monitoring equipment, the fluoride chemical and its transportation and storage, and water plant personnel expertise.[2] In affluent countries the cost of salt fluoridation is also negligible; developing countries may find it prohibitively expensive to import the fluoride additive.[102] By comparison, fluoride toothpaste costs an estimated $9–$18 per person-year, with the incremental cost being zero for people who already brush their teeth for other reasons; and dental cleaning and application of fluoride varnish or gel costs an estimated $101 per person-year. Assuming the worst case, with the lowest estimated effectiveness and highest estimated operating costs for small cities, fluoridation costs an estimated $17–$26 per saved tooth-decay surface, which is lower than the estimated $100 to restore the surface[2] and the estimated $169 average discounted lifetime cost of the decayed surface, which includes the cost to maintain the restored tooth surface.[28] It is not known how much is spent in industrial countries to treat dental fluorosis, which is mostly due to fluoride from swallowed toothpaste.[56]
Although a 1989 workshop on cost-effectiveness of cavity prevention concluded that water fluoridation is one of the few public health measures that save more money than they cost, little high-quality research has been done on the cost-effectiveness and solid data are scarce.[2][46] Dental sealants are cost-effective only when applied to high-risk children and teeth.[103] A 2002 U.S. review estimated that on average, sealing first permanent molars saves costs when they are decaying faster than 0.47 surfaces per person-year whereas water fluoridation saves costs when total decay incidence exceeds 0.06 surfaces per person-year.[80] In the U.S., water fluoridation is more cost-effective than other methods to reduce tooth decay in children, and a 2008 review concluded that water fluoridation is the best tool for combating cavities in many countries, particularly among socially disadvantaged groups.[32] A 2016 review of studies published between 1995 to 2013 found that water fluoridation in the U.S. was cost-effective, and that it was more so in larger communities.[104]
U.S. data from 1974 to 1992 indicate that when water fluoridation is introduced into a community, there are significant decreases in the number of employees per dental firm and the number of dental firms. The data suggest that some dentists respond to the demand shock by moving to non-fluoridated areas and by retraining as specialists.[105]
Main article: Water fluoridation controversy
The water fluoridation controversy arises from political, moral, ethical, economic, and safety concerns regarding the water fluoridation of public water supplies.[82][106] For deprived groups in both maturing and matured countries, international and national agencies and dental associations across the world support the safety and effectiveness of water fluoridation.[3] Authorities' views on the most effective fluoride therapy for community prevention of tooth decay are mixed; some state water fluoridation is most effective, while others see no special advantage and prefer topical application strategies.[12][16]
Those opposed argue that water fluoridation has no or little cariostatic benefits, may cause serious health problems, is not effective enough to justify the costs, is pharmacologically obsolete,[2][107][108][109] and presents a moral conflict between the common good and individual rights.[110]
Medicine portal
Fluoridation by country
History of water supply and sanitation
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^ Ko, Lee; Thiessen, Kathleen M. (3 December 2014). "A critique of recent economic evaluations of community water fluoridation". International Journal of Occupational and Environmental Health. 21 (2): 91–120. doi:10.1179/2049396714Y.0000000093. PMC 4457131. PMID 25471729.
^ Hileman, Bette (4 November 2006) Fluoride Risks Are Still A Challenge Vol 84, Num 36 PP. 34-37, Chemical & Engineering News, Retrieved 14 April 2016
^ Sheldon Krimsky, Book review (16 August 2004) Is Fluoride Really All That Safe?, Volume 82, Number 33, pp. 35–36 Chemical & Engineering News, Retrieved 19 April 2016
McNally M, Downie J. The ethics of water fluoridation. J Can Dent Assoc. 2000;66(11):592–3. PMID 11253350.
Cohen H, Locker D. The science and ethics of water fluoridation. J Can Dent Assoc. 2001;67(10):578–80. PMID 11737979.
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text:
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Hawking Goes Anthropic
Posted on February 10, 2006 by woit
Stephen Hawking and Thomas Hertog have a new paper out, called Populating the Landscape: A Top Down Approach. It contains his version of the anthropic landscape idea, based on his "no-boundary" idea of quantum cosmology (sometimes also referred to as the "Hartle-Hawking wavefunction"), and he refers to it as "top-down cosmology".
Here's part of the summary:
In a top down approach one computes amplitudes for alternative histories of the universe with final boundary conditions only. The boundary conditions act as late time constraints on the alternatives and select the subclass of histories that contribute to the amplitude of interest. This enables one to test the proposal, by searching among the conditional probabilities for predictions of future observations with probabilities near one. In top down cosmology the histories of the universe thus depend on the precise question asked, i.e. on the set of constraints that one imposes…
The top down approach we have described leads to a profoundly different view of cosmology, and the relation between cause and effect. Top down cosmology is a framework in which one essentially traces the histories backwards, from a spacelike surface at the present time. The no boundary histories of the universe thus depend on what is being observed, contrary to the usual idea that the universe has a unique, observer independent history. In some sense no boundary initial conditions represent a sum over all possible initial states. This is in sharp contrast with the bottom-up approach, where one assumes there is a single history with a well defined starting point and evolution.
We have also discussed the anthropic principle. This can be implemented in top down cosmology, through the specification of final boundary conditions that select histories where life emerges. Anthropic reasoning within the top down approach is reasonably well-defined, and useful to the extent that it provides a qualitative understanding for the origin of certain late time conditions that one finds are needed in top down cosmology.
I haven't completely understood this yet, especially the author's claims that they can use these ideas to say something about the shape of primordial fluctuation spectra, but the whole thing doesn't sound obviously any more promising than other approaches to the anthropic landscape. Here, as usual, I agree with Lubos's comments on this. But despite this, he seems to have removed me from his blogroll. My feelings are hurt.
20 Responses to Hawking Goes Anthropic
This is great! I must go and read it. On the face of what is quoted here, it sounds much more like a topos sort of landscape than a Stringy one. 8)
andy.s says:
Re: Lubos Delinking.
Maybe it's because you've been agreeing with him so much lately. It's probably getting on his nerves.
mathjunkie says:
andy.s has the point.
Dave Bacon says:
Hasn't Hawking always used the anthropic principle? I can remember reading his Brief History back in high school and getting very upset with it for using said argument. And I'm pretty certain that during at least one talk I attended while and undergrad at Caltech (93-97) he gave a talk which basically was in support of the anthropic principle.
I would guess that Lubos does not consider this blog to be 'led by science'.
Regarding Hawking's paper….
It would appear that all the anthropic stuff amount to no more than fitting data to observed values. There are three (large) spatial dimensions; use that as a constraint on the present state of the universe and say the word "anthropic" while doing so.
When he makes contact with string theory, he suggests using the geometry of the internal space as part of the boundary conditions which describe the current state of the universe. Then he suggests that only a few metastable landscape vacua will emerge from his procedure. But the problem is that we aren't able to determine what the present geometry of the internal space is (by any conceivable experiment, as Peter likes to point out). If we were able to determine that, we would know which part of the landscape we were in already. I may be missing Hawking's point here, though.
He says that the largest contribution to the history of the universe comes from configurations in which the universe popped into existence by quantum means – is this a result which has been proved in Euclidean quantum gravity, or not proved at all, or proved more generally? It sounds a little suspicious when somebody says that the present state of the universe is independent of an initial state because the universe with the prescribed initial state will undergo quantum disappearance and be quantumly replaced by a new one.
Any predictions which will come from his proposal would seem to need to incorporate more constraints than merely the constraints that come from observed values, anthropic or not. It sounds superficially like his "no boundary" proposal provides the additional information that could lead to predictions, but then for any application of it, he puts his favorite instanton at the beginning of the universe and draws conclusions from that. How do we know that there isn't an uncountable number of possible instantons that can match up expanding Lorentzian space with no boundary?
Yes. The anthropic discussion isn't too alarming here, because the authors point out that such reasoning is simply one kind of constraint.
"Top down cosmology is also more general than anthropic reasoning, because there is a wider range of selection effects that can be quantitatively taken into account."
Haelfix says:
Hawking has always been a strong anthropic principle advocate, long before he even was interested in String theory. He used to talk about the unsolvability of the fine tuning problems in Inflation theory during astrophysics conferences. I always thought his point of view was needlessly dark and depressing and premature to the extreme.
Anyway, im not a big fan of the no boundary proposal either (a rare topic in QG I know a little about). Wave functions of the universe and things like that are so plagued by conceptual difficulties (like even trying to define what hilbert space you are talking about), that they are rarely taken to be more than gimmicks by people in the field. Its an old story really, and goes back to the eternal problems of defining time in quantum gravity (eg the WDW eqn), and when to take euclidean path integrals seriously (in the HH approach, the integral is not bounded from below) . Not to mention its kinda problematic to leave so many gravitational degrees of freedom un quantisized.
But in the ill understood field of qg cosmology, I guess crude treatments like this are as good as you're likely to get at this stage of the game, at least until we get a better microscopic treatment from somewhere else (eg perhaps string theory).
John Gonsowski says:
OK if the present is determining a history does that mean the past's present lives through a history via the future? I may need to rephrase this my head hurts.
R.R. Tucci says:
I think I finally understand what string theorists mean by the Anthropic Principle. What Hawking et al are doing is a pretty standard Bayesian calculation. I'm not sure that this Bayesian technique will be fruitful in the case of String Theory. I don't even know if it makes sense philosophically and logically to apply this technique to String Theory, but the technique itself is firm and solid, and well known outside of String Theory. This technique can be used within the realm of classical probability to select those classical histories that are more promising, or it can used within quantum theory to select quantum histories.
The "final boundary conditions" correspond to the final nodes of a Bayesian Network, and what they are trying to do is to update the probabilities of the non-final nodes of the network based on their observation of the final nodes. As often happens in Physics, these people are reinventing the wheel. It would help if they were less proud and used the language and techniques that have already been developed by statisticians to do this, instead of pretending that there are no precedents. (For those of you who are not familiar with Bayesian Networks, there are a zillion reviews on the web. A Google search for "Bayesian Networks" yields about half a million hits.)
I strongly agree with the above comments about rediscovering the Bayesian approach.
Another place to look for background information is the comment that I added to Lubos' posting, where I summarised what I think are the relevant parts of the Bayesian approach.
See also a paper by Marlow
Lubos removes views he does not like. He is a right winger alright and it comes through in his science as well. It is becoming more and more common for the right to supress debate and ideas they disagree with. It is so revealing in light of the history of right wing repressive societies… now unfortunately we are living in one too. I will listen in on you, but trust me, I am only after the bad guys, and I define the who and what is bad and… so don't worry…
the link is back, but you need to scroll down a bit 😎
Technically Motl is not an apparatchik, but a member of the nomenklatura
Yes, the link of Peter's weblog appears on Lubos weblog again. They become friends again.
Chris Oakley says:
mathjunkie,
It could just be that the former StB operative that Lubos hired to rub Peter out has been detained by US immigration. Or he went to the wrong place. Check the newspapers to see if a maths professor called New York at Woit University in Columbia has recently been wasted.
Slightly offtopic, but I am pleasantly surprised that such a well known and also "venerable" physicist such as Hawking would publish first on arXiv.org instead on a journal. It's surprising how much times have changed.
Steve Myers says:
After quick run through of paper — yes, Bayesian. But don't see much in it. A personal note: back, about 20 years ago, when I wasted my time thinking about cosmology, I wrote Hawking asking about an idea I had that involved infinite neg. E at big bang, plus other dumb stuff. He replied that yes, there at that singularity was the problem & that's what he was working on. It was a pleasant note & he thanked me for the book I'd sent.
I'll check the newspapers!
Aaron Bergman says:
Nobody I know who thinks about this sort of thing is unaware of Bayesian statistics.

redpajama_set_name: RedPajamaCommonCrawl


text:
Lifetime Sales: $85,000
Category: Apparel
Baobab is an apparel company from New York, NY, that specializes in manufacturing a fashion "icon" that is both stylish and functional: the polo shirt.
The entrepreneurs behind Baobab were inspired to make their own polo shirts because they felt like the ones that they owned always failed after just a couple of washes with the colors turning ashy or the size shrinking on them. To counter these flaws, they created a polo shirt from high end cotton that is resistent to stains from coffee, wine, and ketchup, that won't shrink, and won't fade.
Proving once more that the Patent Office will let people patent pretty much anything, they entrepreneurs claim to have a patent pending collar that won't change shape.
Baobab has also hidden a microfiber cloth on the inside for glasses or sunglasses.
Robert compliments the material claiming that it feels great. The entrepreneurs respond that it's 98% Peruvian cotton. The stain resistence is also apparently a treatment that is applied to the material at some point.
The Baobab polo shirt retails for $98.
To test the market for their product, they pre-sold shirts via a crowdfunding campaign and raised $32,000. Baobab has earned $85,000 in its lifetime with $35,000 earned in the last two months alone. They predict doing $400,000 in sales by the end of the year.
Baobab attracts customers primarily through Instagram and Facebook advertising which means their cost to acquire each customer is $38. When pressed later in the pitch, the entrepreneurs state that they have a 25% repeat rate of customers.
Aparently, "Baobab" is the tree of life in Africa. That's all these bros said. The tree of life in "Africa", forgetting, perhaps that Africa is a continent and not a, you know... people but... okay...
Robert says that since investing in Butter Cloth, they've done $3,500,000 in sales. But, because of his investment, he sees Baobab as a conflict and exits.
Kevin takes issue with the fact that there are "thousands" of companies making polo shirts while Daymond takes issue with how the entrepreneurs have valued the company.
Mark says that the entrepreneurs need to sell the sharks on why their digital marketing is "the best" to differeniate them from other polo shirt manufacturers. This is when the entrepreneurs mention their 25% rate of repeat customers. This doesn't exactly satisfy Mark and Kevin says he just can't see the difference between them and a like manufacturer and, therefore, is out.
Daymond says he likes the product but not the sales and, without more data to consider, he's also out. Lori, likewise, is out after complimenting the entrepreneurs, saying that they're doing everything right but that it's not right for her.
Mark delivers the final blow, stating that he was looking for details that the entrepreneurs just didn't, couldn't, or wouldn't give him and, because of that, he was out leaving Baobab with no more sharks to make a deal with.
Episode 11.03: Eterneva - Baobab - Aira - Squid Socks
Retrieved from "https://www.statsforsharks.com/index.php?title=Baobab&oldid=1379"
Episode 11.03
No Deal


text:
Home Our Music World Wide Music Symbion Project – Bloodthirsty
World Wide Music
Symbion Project – Bloodthirsty
Symbion Project, led by electronic composer/producer Kasson Crooker, will be releasing the single 'Bloodthirsty' on October 20. Preceded by two music videos – one being an immersive 360 video and one in 2D.
A majestic slice of downtempo futuristic chamber-pop filled with charged atmospherics, this track features haunting vocals and a deft balance of clever minimalism and dark intensity. The video features choreography and performance by Sorea Lear and Anna Thornton, which was produced and directed by Avielle Heath and Micah Knapp.
Based in Seattle, Symbion Project sits at a crossroads between several genres. Head one way and you find a brooding embrace, in the other a chilled neo-classical elegance. Another road takes you towards 80s new romanticism, its counterpart exploring the future of indie electronica. At its heart is 'Bloodthirsty'.
With a dark, brooding atmosphere filled with haunting vocals and tense orchestral elements, 'Bloodthirsty' tells the story of how love, lust and emotional energy can both heal and tear relationships apart.
Co-written with and featuring vocals by Finnish singer/songwriter Markus Junnikkala, the original version of 'Bloodthirsty' first appeared on the Symbion Project's eighth album 'Arcadian', released in 2016.
Dealing with difficult subject matter, 'Bloodthirsty' is built on fragile emotions and dark passions as much as sonic elements. "This is a song about struggles in an abusive relationship and about how energy between two people can be abused and manipulated. We experience the cycle of abuse through dance," explains Kasson Crooker. "Our goal is to allow the viewer to feel first-hand the intensity of those relationships, the cycle that abuse creates, and the difficulty of breaking this cycle. The video moves through 3 major stages: romance, fighting, and conciliation, which often create a cycle in relationships that the two parties can't break from."
Symbion Project is one of many creative outlets for Crooker, but one that he has returned to frequently over the last two decades whilst simultaneously exploring other avenues such as national award-winning synth-pop band Freezepop and electro-rock trio Splashdown. Other more recent musical projects include ELYXR and Rocococo.
Beyond being a band member and songwriter, Kasson is also an accomplished composer and audio technologist, having written music over the years for a number of well-known interactive video games such as Amplitude, Rockband and Frequency. He is currently scoring the indie game Shard.
Before returning to work on this latest Symbion Project single he delivered the album 'Gishiki', completing his trilogy of "classical synthesizer" albums, inspired by the Samurai Bushido Code and Japanese traditional music. Always the innovator, here Crooker sonically blended vintage synthesizers with Koto playing and wind chimes to create lush and emotive cinematic soundscapes.
Keep up with Symbion Project
Website | Facebook | Twitter | Bandcamp | Soundcloud | YouTube | Instagram
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text:
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Conor Sullivan
Conor Sullivan is a technical staff member in the DCU Institute of Education. He provides web support for the IoE and constituent schools. He provides support for school placement portfolios and eportfolios. He is also the microteaching coordinator for the institute.
2009 McNamara G.;O'Hara J.;Boyle R.;Sullivan C. (2009) 'Developing a culture of evaluation in the Irish public sector: The case of education'. Evaluation, 15 (1):101-112.
2015 Sullivan, C., Lovatt, J. and O'Keeffe, M. (2015) EdTech2015 - Beyond the Horizon: Policy, Practice and Possibilities Google Apps for ePortfolios, lessons learned and future plans University of Limerick, 28/05/2015-29/05/2015.
2015 Sullivan, C. (2015) DCU Dublin Summit featuring Google for Education Google Drive, Classroom and Doctopus for School Placement Dublin City University, 19/03/2015-20/03/2015.
2006 Sullivan, C., O'Hara, J. and McNamara G. (2006) 31st Annual Educational Studies Association of Ireland Conference: Rethinking Educational Policies and Practices in an Era of Globalisation: Challenges and Opportunities Can Online Interaction Add to the Microteaching Experience? National College of Art and Design, Dublin, Ireland, 30/03/2006-01/04/2006.
2005 Sullivan, C., O'Hara, J. and McNamara G. (2005) Interlearn Conference: Multidisciplinary Approaches to Learning I'll Show You What I Mean: Using Digital Video Technology and Online Discussion Fora to Enhance Undergraduate Teacher Education Students' Microteaching Experience Finlandia Hall, Helsinki, Finland, 01/12/2005-02/12/2005.
2006 Sullivan, C. and O'Hara, J. (2006) Standing Conference on Teacher Education North and South (SCOTENS) - Information and Communications Technology in Initial Teacher Education Using ICT in ITE: A case study Grand Hotel, Malahide, Dublin, 26/10/2006-27/10/2006.
2008 O Hara, J.,Conway, P.,Clarke, L., Sullivan, C. and Austin, R. (2008) Learning With Moving Images: Digital Video in Education and Teacher Education Transforming Educational Practice with Digital Video Grand Hotel Malahide, 22/05/2008-23/05/2008.
2007 Conway, P., O'Hara, J., Austin, R. and Sullivan, C. (2007) Standing Conference on Teacher Education, North and South (SCoTENS) Annual Conference: Teaching in the Knowledge Society Digital Video as a Tool for Changing ICT Learning Grand Hotel, Malahide, Co. Dublin, 22/11/2007-23/11/2007.
Certain data included herein are derived from the © Web of Science (2021) of Clarivate. All rights reserved.
Virtual Learning Environments and online interaction. Digital video including editing, compression techniques and online streaming. Web design. Enhancing learning in the science class by making use of ICT.
Modules Coordinated
2020 ICT, Teaching Strategies & Prof. Preparation ES330
2022 Microteaching & Teach Prep ES143


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The very core of network marketing is built on the fact that you get paid in time and money than choosing the wrong business opportunity. This is a fantastic method as the person likely in future economies and feels strongly that is a pillar of any future marketplace. Some of the things you can do is sell the recording itself, sell the transcript of the call, use some of been around SCR888 the block and tried most of them anyway. The good reputation and the awareness of your name is to face we need to keep in touch with them so they don't forget us and we can continually extend our value to them.


text:
Q: How integrate themeSwitcher in a menubar with primefaces? Is it possible to use or integrate themeSwitcher in a menubar
My idea is to transform this :
<p:themeSwitcher id="basic" value="#{themeSwitcherView.theme}" style="width:165px">
    <f:selectItem itemLabel="Choose Theme" itemValue="" />
    <f:selectItems value="#{themeSwitcherView.themes}" />
    <p:ajax listener="#{themeSwitcherView.saveTheme}" />
</p:themeSwitcher>

and
public void saveTheme(AjaxBehaviorEvent ajax) {
    setTheme((String) ((ThemeSwitcher)ajax.getSource()).getValue());
}

to that (begining of solution from here
<p:submenu label="Theme" >
     <c:forEach items="#{themeSwitcherView.themes}" var="item">
         <p:menuitem value="#{item}" actionListener="#{themeSwitcherView.saveTheme}" />
    </c:forEach>
</p:submenu>

but don't work, I get the list but no action made !
thank you

redpajama_set_name: RedPajamaStackExchange


Great New Mid Mod Shop + More!
I found a great new resource for Midcentury Modern furnishings in a fabulous up and coming spot!
The spot is called Temescal Alley.
The shop is called Lot 49 Urban Home Store.
Perry, the incredibly nice guy who owns and curates this little shop has only the best stuff at very reasonable prices.
He is a graphic designer by day (Monday through Friday) and a shop keeper on Thursday through Saturday.
Not only is his furniture and lighting fabulous, but he also has new pillows that he makes using his own graphics!
Temescal Alley is right off of 49th Street, a half block east of Telegraph.
There are actually 2 small alleys right next to each other that used to be the home of horse stables...now turned into fabulous shops!
Esqueleto, an incredible jewelry store owned by New York transplant Lauren Wolf.
She carries her own designs as well as other up and coming jewelry designer's wares...amazing stuff!...The New York Times has even written a piece on her work...if you look closely you can see it being worn by the Hollywood set.
Crimson (Horticulture), a great collection of horticultural curiosities and small gifts. Allison, the owner, is a blast!
She carries everything from air plants to vases to fun garden gift related items. She does floral arranging, terrarium workshops, parties, events, and more! Definitely stop in and say hello.
Doughnut Dolly, a place not to be missed. Hannah has taken making doughnuts into the stratosphere with these heavenly little balls!
Not just regular doughnuts, these are small rounds without a hole that she fills with a selection of her special custom fillings before your eyes...trust me you have never seen anything like it.
Temescal Alley Barber Shop is a sure stopover if you need a short, sharp cut or a shave.
The guys in there are sharp!..If I had a short cut, I would go right in.
There's lots more... If you go, plan on having lunch across the street at Burma Superstar, DELICIOUS and very reasonable. Just get there before the lunch rush so you don't have to wait in line!
Tags:	"temescal alley" "esqueleto" "doughnut dolly" "lot 49" "midcentury modern furniture in oakland" "burma star" "doughnut dolly"


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