Celivia

I take your point about fluoride already being present in water (totally agree it prevents cavities). Knowing as I do, the my young cousins are growing up off the town water grid, they have excellent healthy teeth, assume that fluoride was already present in tank water. In fact I am more concerned about the levels of chlorine and other chemicals than fluoride.

Shadow Minister

Seeing as I am here already I must bring your attention to a couple of points you made previously.

1. Any part of our bodies that regularly becomes infected are at a higher risk of cancer - for example, infections due to an unretractable foreskin.

2. Regarding your claim about the increased sensitivity of the glans after circumcision. Adult men have reported increased sensitivity for a time after circumcision, this sensitivity decreases as the epidermis toughens and thickens to compensate for the lack of a protective foreskin.

Why you think a temporarily increased sensitivity of the glans would be advantageous for baby boys is something you need to clarify.

Cheers

Fluoridation is necessary for our kids to have less cavities and for less gum disease and dentistry work needed when they grow into adults.

Circumcision, on the other hand, is totally unnecessary unless a baby/boy/man has a medical need for such a procedure.

Luckily, these days it is no longer routinely carried out like it was when I was a very young nurse.
I had to hold babies down while the doctor cut off the foreskin. Believe me, the babies were extremely distressed and looked to be in severe pain.
There was no anaesthetic for them, and no pain relief was given. I was distressed as well.

If any parents want to have their babies circumcised for no reason other than they like the way a circumcised penis looks, or because daddy had it done, then they should be made to hold their babies down themselves while the procedure is done.

Cornflower,

From your posts it is obvious that you haven't actually read the RACP statements on the issue. Do you actually just make up everything as you go along?

If you bothered to read the statements and other articles you would find that they support what I have been saying:

They recommend appropriate anesthetic (local or topical for routine cases with infants.)

General anesthetic is only indicated where there are complications for example in teens where there is infection or other issues where the surgery is no longer simple. (where the simple procedure as an infant would have saved a lot of trauma.)

They also state that the risk of harm is so low that they cannot recommend against doing the procedure, and that it should be left to the discretion of the parents.

They also recognize that there are benefits, but that they are not sufficient to recommend it as a routine procedure.

I grew up on tank water in PNG. The pump had a compartment for inserting fluoride tablets, which then dissolved as the pump was used.

I'm now 46 and despite years of neglect my teeth are in much better shape than they have any right to be. My gums, on the other hand, are buggered, largely due to the years when I smoked heavily, I suspect.

The point is that gum disease is at least as big a problem as tooth disease - possibly even bigger. Fluoridation will help to keep the teeth strong, but only excellent oral hygiene will maintain the gums in health over the long term.

I'm all in favour of fluoridation, but lets make sure that the oral hygiene message isn't forgotten.

Cornflower,

Your opinion based on the Royal Australian College of Physicians comments are understandable but:

”To reduce the risks and the discomfort for the child, the operation is best performed under a general anaesthetic after the age of six months.”

Well that is a really intelligent recommendation isn’t it? Wait until they experience more pain, expose them to the risks of general anaesthetic, and have them newly cut when they are more mobile. Somehow that will reduce the risks and discomfort for the child.

“The circumcision decision is easily made on scientific facts available from the medical profession and hospitals and the emphatic answer is "No".”

I agree with the frst bit but not the second bit. Anyway since you naturally attribute so much importance to the RACP information please consider their full policy statement where the following quote was lifted.

"After extensive review of the literature, the Paediatrics & Child Health Division of the Royal Australasian College of Physicians has concluded that there is no medical reason for routine newborn male circumcision.”

That is from their policy statement which, as you can see on the page of the link you provided is under revision. That is not to say that I’m expecting them to be at the forefront of medical research just yet given the existing policy statement. That will depend on the attitude and composition of the team doing the revision. Everything so far is pretty embarrassing. I know an RACP statement sounds impressive and it has influenced public hospital policy and no doubt the view of many medical practitioners who repose confidence in it. Therefore on the face of it I sound like a redneck condemning it so don’t worry I’ll go into some detail.

In the first section it authoritatively states:

“The complication rate of neonatal (nb. neonatal) circumcision is reported to be around 1% to 5%...”.

Later it states:

“The true incidence of major (major is in bold) complications after newborn (nb. newborn) circumcision is unknown but is reported to be from between 0.2% and 0.6%5 to 2%-10%61 This time it is referenced.

TBC

The 0.2% and 0.6% I know relate to huge studies of neonates/newborns undergoing the procedure. They reference it to the American Academy of Pediatric statement at the time.

In that statement it relevantly states: “Reports of two large series have suggested that the complication rate is somewhere between 0.2% and 0.6%. Most of the complications that do occur are minor." (NB. minor)

For the record the first study referred to by the AAP was a ten year study that looked at 5,882 neonatal procedures and the second I can’t put my hand on this second but I know it also had a big sample.

The 2% -10% is referenced to a British Journal of Surgery article which simply states that a realistic figure is 2-10%. That is referenced to 3 other papers. One looks at complications in a hospital with a sample of 140 and a mean age of 4.3 with ONLY 6 in the first year of life. One just refers to 3 other papers. One with a sample of 200, and a study from the 60s finding 1.5 to 5% that I can’t source and a 1952 study that I can’t source but from its title clearly looked at 4 year old children ONLY. The final reference of the original British Journal of Surgery article has a sample of 100 with a mean age of 4.7.

In other words the only big samples appear to give complication rates of 0..2% and 0.6%. Of the others that are locateable all are small samples and typically don’t consider neonates exclusively or at all.

Then you get to the issue of the word “major” in bold. Yet in all cases the issue was overall complications and the AAP statement specifically stated that most complications are minor.

So on the best available evidence based on their references the risk estimate is inflated by about tenfold and their references provide no basis for doing so (it is undisputed that later circumcision is more risky). They also describe minor risks as major and curiously put the word major in bold.

TBC