I read yesterday that Alan Johnson, the Health Minister here in the UK, is going to call this week for the practice of water fluoridation to be extended here in the UK. Currently about 10 per cent of the UK population is piped fluoridated water, something that is that we are told would reduce dental decay in a stroke. In support of this, we are reminded that dental decay rates in Manchester (where the tap water is non-fluoridated) are about twice those in Birmingham (where the water has been fluoridated for 40-odd years). This impressive sounding statistic becomes a little less impressive when you realise it really is no more scientifically tenable that the observation that because Japanese men smoke a lot but are generally long-lived, smoking must be good for us.
If the Government, aided and abetted by the British Dental Association and other pro-fluoride groups wanted to make a case for water fluoridation then they could do worse that to refer to real science. The most comprehensive review of this practice was published in the British Medical Journal in the year 2000 [1], and is commonly referred to as the ‘York Study’. This review found that just one in six individuals drinking fluoridated water appears to benefit from this practice. Correct my if I’m wrong, but I believe that this level of effectiveness is quite disappointing in comparison to almost panacea-like image so often painted for fluoride.
And what’s more, the York Study revealed that about half of individuals who drink fluoridated water will suffer from ‘dental fluorosis’ ” mottling and discolouration of the teeth caused by fluoride excess. A more recent review of the evidence found similar rates of dental fluorosis in those drinking fluoridated water [2]. So, let’s just be clear about this, the best available evidence we have is that water fluoridation reduces dental disease in one in six, but causes dental problems in one in two.
Now, when you start to look at this cold hard facts about water fluoridation it perhaps come as no surprise that those who support water fluoridation like to stay clear of the science: Much better to draw comparisons between dental decay rates in Manchester and Birmingham and hope that no-one notices what nonsense and just how much a distortion of the truth this is.
But wait, it gets worse. Fluoride is potentially toxic not just to the teeth, but other parts of the body including the bone, brain and endocrine (hormonal) system. More information on the potential hazards of fluoride can be found here.
And here’s another thing: the practice of water fluoridation basically amounts to mass medication of the population, no? Some would say that that’s an infringement of civil liberties. But let’s think a little more deeply about this: water fluoridation is mass medication that takes no account of the medical history of the individual nor their need for the ‘medication’. And the ‘dose’ of the medication (which has very real potential for harm) is not specified or monitored in any way. No, the dose of fluoride that people ingest from tap water is essentially determined by thirst.
Does any of this seem like good, effective, safe and ethical healthcare to you? Not to me.
Those of you who feel you’d like to share your views on this matter with Alan Johnson MP can contact him here.
As an addendum, I’d like to add a letter written by Ian Wylie, the Chief Executive of the British Dental Assocation, in response to a column in which I had been critical of water fluoridation published in the Observer. In this piece I specifically mentioned the York Study, and the fact that it showed only one in six benefits from the practice of water fluoridation.
Note that Ian Wylie’s response is very rich in rhetoric, but how while he refers to the science, he neglects to cite any. Notice too, that there’s no mention of the York Study. I wonder why not.
Sunday October 13, 2002
The Observer
In questioning the medical and ethical rationale behind water fluoridation, Dr John Biffa (OM, last week) ignores the oral health benefits of this policy.
Targeted water fluoridation is an acknowledged method of decreasing dental disease. Tooth decay remains a significant public health problem in the UK – particularly in socially deprived communities. This is why the British Dental Association campaigns for targeted fluoridation based on sound science.
The Medical Research Council recently reiterated its view that fluoridation reduces tooth decay and gave reassurance on wider health issues related to fluoridation. The BDA welcomed its call for further research and would expect this to include population studies where local communities want fluoridation.
Ian Wylie
Chief executive, British Dental Association
London W1
References:
1. McDonagh M, et al. Systematic Review of Water Fluoridation BMJ 2000;321:855-859
2. Pizzo G, et al. Community water fluoridation and caries prevention: a critical review. Clin Oral Investig. 2007 Feb 27; [Epub ahead of print]
Related links:
