Ireland - Fluoridation is wonderful says expert
The benefits of water fluoridation
T here is overwhelming scientific evidence that water fluoridation significantly benefits dental health and, through this, benefits overall health. As an Irish public health policy implemented for more than 40 years, water fluoridation has been the single most effective and efficient method for delivering fluoride for the benefit of all sections of society, irrespective of social and economic position.
Following the introduction of fluoridation in the Republic, surveys reported mean decayed, missing and filled teeth (dmft) rates of 1.8 in five-year-olds living in fluoridated areas of the Republic in 1984. In comparison, the average dmft in five-year-olds living in non-fluoridated Northern Ireland in 1984 was 4.5. This is in contrast to the pre-water fluoridation situation where there was little difference between the caries experience of children in the two jurisdictions. This study has been recently repeated, and preliminary analysis of the data again highlights the benefits of water fluoridation. If water fluoridation is discontinued, decay rates in the Republic would increase significantly and the negative effects would be felt greatest by the more disadvantaged sections of society.
Water fluoridation in Ireland dates back to the early 1960s. All peer reviewed studies are studied by Irish experts as part of the ongoing review of its safety and effectiveness. Water fluoridation continues to be essential in counterbalancing continuingly poor tooth brushing habits and high rates of snacking on sugary foods and drinks, behaviours where Irish teenagers compare poorly with their European peers. As a public health policy, water fluoridation has resulted in a 40 per cent reduction in decayed, missing and filled teeth in Ireland for children living in areas supplied by fluoridated drinking water.
The effectiveness of water fluoridation in preventing dental decay also continues to be endorsed by a comprehensive range of international bodies including the World Health Organisation (WHO) and the Centre for Disease Control and Prevention, which has described it as one of the 10 most important public health advances of the 20th century.
One of the concerns frequently raised about fluoridation is its contribution to increased levels of fluorosis among the general population. Dental fluorosis is a cosmetic effect that can be redressed although this is rarely needed for the level which can be attributed solely to fluoride in optimally treated water supplies. While levels of fluorosis remain low in Ireland and, for the most part, take the form of white spots in the tooth enamel, the Minister for Health and Children has accepted the advice both of the Forum on Fluoride and the Expert Body on Fluorides and Health (set up as in response to the Forum’s report) to lower the current level of fluoride in drinking water to a range of 0.6 to 0.8 parts per million (ppm) from the level of 0.8 to 1.0 ppm set in the 1960s before the advent of fluoridated toothpastes.
Concern has been raised by some around the American Dental Association’s recent provisional recommendation that parents should consider using water that is fluoride-free or contains low levels of fluoride when reconstituting infant formula. While this advice is appropriate for the US, where drinking water may contain fluoride at up to four ppm, it is not appropriate for Ireland, where levels of fluoride are up to four times lower. As such, the Expert Body continues to advise that infant formula should be reconstituted with boiled tap water. It should also be noted that, based on research commissioned by the Forum on Fluoridation, no difference was found between the dental enamel of infants who were breast-fed and those who received infant formula reconstituted with tap water.
Data available to date support the continuation of water fluoridation policies. The epidemiological evidence that fluoride protects against dental caries is strong. Concerns about adverse effects other than dental fluorosis from optimally fluoridated water supplies have not been substantiated. As in all other areas of healthcare provision due regard should and will be taken of findings of ongoing quality research in this area so that the optimal format and degree of fluoridation can be harmonised with the changing health needs of the population. The Expert Body on Fluorides and Health’s view is that fluoridation of Ireland’s drinking water continues to be a crucial and beneficial healthcare policy.
Dr Márie O’Connor, Specialist in Public Health Medicine, Member of the Expert Body on Fluroides and Health
T here is overwhelming scientific evidence that water fluoridation significantly benefits dental health and, through this, benefits overall health. As an Irish public health policy implemented for more than 40 years, water fluoridation has been the single most effective and efficient method for delivering fluoride for the benefit of all sections of society, irrespective of social and economic position.
Following the introduction of fluoridation in the Republic, surveys reported mean decayed, missing and filled teeth (dmft) rates of 1.8 in five-year-olds living in fluoridated areas of the Republic in 1984. In comparison, the average dmft in five-year-olds living in non-fluoridated Northern Ireland in 1984 was 4.5. This is in contrast to the pre-water fluoridation situation where there was little difference between the caries experience of children in the two jurisdictions. This study has been recently repeated, and preliminary analysis of the data again highlights the benefits of water fluoridation. If water fluoridation is discontinued, decay rates in the Republic would increase significantly and the negative effects would be felt greatest by the more disadvantaged sections of society.
Water fluoridation in Ireland dates back to the early 1960s. All peer reviewed studies are studied by Irish experts as part of the ongoing review of its safety and effectiveness. Water fluoridation continues to be essential in counterbalancing continuingly poor tooth brushing habits and high rates of snacking on sugary foods and drinks, behaviours where Irish teenagers compare poorly with their European peers. As a public health policy, water fluoridation has resulted in a 40 per cent reduction in decayed, missing and filled teeth in Ireland for children living in areas supplied by fluoridated drinking water.
The effectiveness of water fluoridation in preventing dental decay also continues to be endorsed by a comprehensive range of international bodies including the World Health Organisation (WHO) and the Centre for Disease Control and Prevention, which has described it as one of the 10 most important public health advances of the 20th century.
One of the concerns frequently raised about fluoridation is its contribution to increased levels of fluorosis among the general population. Dental fluorosis is a cosmetic effect that can be redressed although this is rarely needed for the level which can be attributed solely to fluoride in optimally treated water supplies. While levels of fluorosis remain low in Ireland and, for the most part, take the form of white spots in the tooth enamel, the Minister for Health and Children has accepted the advice both of the Forum on Fluoride and the Expert Body on Fluorides and Health (set up as in response to the Forum’s report) to lower the current level of fluoride in drinking water to a range of 0.6 to 0.8 parts per million (ppm) from the level of 0.8 to 1.0 ppm set in the 1960s before the advent of fluoridated toothpastes.
Concern has been raised by some around the American Dental Association’s recent provisional recommendation that parents should consider using water that is fluoride-free or contains low levels of fluoride when reconstituting infant formula. While this advice is appropriate for the US, where drinking water may contain fluoride at up to four ppm, it is not appropriate for Ireland, where levels of fluoride are up to four times lower. As such, the Expert Body continues to advise that infant formula should be reconstituted with boiled tap water. It should also be noted that, based on research commissioned by the Forum on Fluoridation, no difference was found between the dental enamel of infants who were breast-fed and those who received infant formula reconstituted with tap water.
Data available to date support the continuation of water fluoridation policies. The epidemiological evidence that fluoride protects against dental caries is strong. Concerns about adverse effects other than dental fluorosis from optimally fluoridated water supplies have not been substantiated. As in all other areas of healthcare provision due regard should and will be taken of findings of ongoing quality research in this area so that the optimal format and degree of fluoridation can be harmonised with the changing health needs of the population. The Expert Body on Fluorides and Health’s view is that fluoridation of Ireland’s drinking water continues to be a crucial and beneficial healthcare policy.
Dr Márie O’Connor, Specialist in Public Health Medicine, Member of the Expert Body on Fluroides and Health
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