UK - Should we fluoridate Britain's water supply?
Should we fluoridate Britain's water supply?
Yes
Dr Nigel Carter, chief executive of the British Dental Health Foundation
I used to practise dentistry on the border of Birmingham, which had been fluoridated and Sandwell, which wasn't. We could tell with 100 per cent accuracy which side of the road children came from by the state of their teeth.
Invariably if we had a child whose address was Birmingham who came in with decay and we quizzed the parent we found that they had just moved into the area. Out of 100 health authorities at that time Sandwell was in the bottom quarter for oral health.
Within five years after fluoridation in 1987, it was in the top ten. It was that dramatic.
There is a lot of scientific evidence around the world in support of fluoridation and the effects that it has. In five-year-olds you are talking about a difference of one or two decayed teeth, and the difference grows as they get older.
There is a lot of evidence to suggest that it is the first decay that you get that sets you up for your lifetime experience. The later that you get your first cavity the better your lifetime oral health is likely to be.
Dental decay is a disease of social disadvantage. It affects poorer people more than it affects the better off. As a result, the arguments put forward of parental responsibility are irrelevant - if you have got problems finding enough money to feed your children the last thing on your mind is replacing toothbrushes or buying fluoride toothpaste.
Fluoridating the water is a costeffective measure which in areas of high decay can give instant results.
There have been no convincing studies done to show any damaging health effects elsewhere in the body. The anti fluoridationists cite poor evidence which simply does not stand up to close examination.
The only effect is a slight increase in fluorosis of the teeth. In the early stages this is simply increased opalescence, making teeth look whiter. People often scream “fluorosis” when they see brown marks on teeth, however this is not always the cause.
There have always been brown marks on teeth which can be due to a disruption in maternal nutrition during pregnancy or illness around birth. Fluorosis is often due to children swallowing toothpaste, drinking fluoridated water and taking fluoride supplements.
We don't object to putting chlorine in the water to stop typhoid or health supplements in bread, it is mass medication, but it is an effective measure.
People forget that fluoride is not an artificial chemical - it occurs naturally in water. In some areas, such as Hartlepool, fluoride is taken out of the water because there is too much and it is necessary to reduce it to the right levels to avoid fluorosis. We are sim- ply adjusting what occurs naturally.
No
Nick Reeves, executive director of the Chartered Institution of Water and Environmental Management
We object to fluoridation on ethical grounds. The Government is treating fluoride as a medication. Except in very exceptional circumstances people cannot be forced to take medication against their will.
In order to be lawful everyone would have to consent to fluoride being added to the water and not just a majority of citizens.
Consequently, this makes mass medication an illegal act that should be tested in the courts. Under the Poisons Act or the Human Rights Act people could sue the Government for forcing people to take medication against their will.
The science on fluoridation is not conclusive. There have been a number of studies around the world and the results have been mixed. Some groups have extreme concerns over the potential damage to health.
Excess fluoride can cause fluorosis of the teeth. It is true that the amounts that Government want to add to the water are tiny. But we don't know what the long-term effects are.
The Government has listened to only one side of the story. Some countries which have used fluoridated water, such as Canada, have now given up using it because they have concerns over the science.
There have been a number of conferences held by scientists and lots of research on the subject. Some say it's a good thing, others are not so sure. The long-term health effects are still unknown. So we say: “Let's err on the side of caution.”
There are alternative ways of dealing with oral health. Why not invest more money in dental healthcare free at the point of delivery? It seems a financially driven decision.
Dental healthcare has declined in recent years - people do not have easy access to it, we all know that it has become extremely difficult to find an NHS dentist. It is very much a postcode lottery.
If we are serious about improving dental healthcare let us make sure that we have good dental provision free at the point of delivery. That way everyone has the opportunity to improve their oral health, particularly in deprived areas.
Adding fluoride to the water looks like a quick fix. It is a very blunt instrument indeed and potentially a risky one, because we don't know what the long-term effects of fluoridation are.
It's not good enough to say “we have had consultations and a large number of people want fluoride in their water”. Because potentially many other people would be horrified, but they do not know about it.
A public debate needs to be held. The public does not have all the facts at its fingertips, so how can it make an informed decision?
Yes
Dr Nigel Carter, chief executive of the British Dental Health Foundation
I used to practise dentistry on the border of Birmingham, which had been fluoridated and Sandwell, which wasn't. We could tell with 100 per cent accuracy which side of the road children came from by the state of their teeth.
Invariably if we had a child whose address was Birmingham who came in with decay and we quizzed the parent we found that they had just moved into the area. Out of 100 health authorities at that time Sandwell was in the bottom quarter for oral health.
Within five years after fluoridation in 1987, it was in the top ten. It was that dramatic.
There is a lot of scientific evidence around the world in support of fluoridation and the effects that it has. In five-year-olds you are talking about a difference of one or two decayed teeth, and the difference grows as they get older.
There is a lot of evidence to suggest that it is the first decay that you get that sets you up for your lifetime experience. The later that you get your first cavity the better your lifetime oral health is likely to be.
Dental decay is a disease of social disadvantage. It affects poorer people more than it affects the better off. As a result, the arguments put forward of parental responsibility are irrelevant - if you have got problems finding enough money to feed your children the last thing on your mind is replacing toothbrushes or buying fluoride toothpaste.
Fluoridating the water is a costeffective measure which in areas of high decay can give instant results.
There have been no convincing studies done to show any damaging health effects elsewhere in the body. The anti fluoridationists cite poor evidence which simply does not stand up to close examination.
The only effect is a slight increase in fluorosis of the teeth. In the early stages this is simply increased opalescence, making teeth look whiter. People often scream “fluorosis” when they see brown marks on teeth, however this is not always the cause.
There have always been brown marks on teeth which can be due to a disruption in maternal nutrition during pregnancy or illness around birth. Fluorosis is often due to children swallowing toothpaste, drinking fluoridated water and taking fluoride supplements.
We don't object to putting chlorine in the water to stop typhoid or health supplements in bread, it is mass medication, but it is an effective measure.
People forget that fluoride is not an artificial chemical - it occurs naturally in water. In some areas, such as Hartlepool, fluoride is taken out of the water because there is too much and it is necessary to reduce it to the right levels to avoid fluorosis. We are sim- ply adjusting what occurs naturally.
No
Nick Reeves, executive director of the Chartered Institution of Water and Environmental Management
We object to fluoridation on ethical grounds. The Government is treating fluoride as a medication. Except in very exceptional circumstances people cannot be forced to take medication against their will.
In order to be lawful everyone would have to consent to fluoride being added to the water and not just a majority of citizens.
Consequently, this makes mass medication an illegal act that should be tested in the courts. Under the Poisons Act or the Human Rights Act people could sue the Government for forcing people to take medication against their will.
The science on fluoridation is not conclusive. There have been a number of studies around the world and the results have been mixed. Some groups have extreme concerns over the potential damage to health.
Excess fluoride can cause fluorosis of the teeth. It is true that the amounts that Government want to add to the water are tiny. But we don't know what the long-term effects are.
The Government has listened to only one side of the story. Some countries which have used fluoridated water, such as Canada, have now given up using it because they have concerns over the science.
There have been a number of conferences held by scientists and lots of research on the subject. Some say it's a good thing, others are not so sure. The long-term health effects are still unknown. So we say: “Let's err on the side of caution.”
There are alternative ways of dealing with oral health. Why not invest more money in dental healthcare free at the point of delivery? It seems a financially driven decision.
Dental healthcare has declined in recent years - people do not have easy access to it, we all know that it has become extremely difficult to find an NHS dentist. It is very much a postcode lottery.
If we are serious about improving dental healthcare let us make sure that we have good dental provision free at the point of delivery. That way everyone has the opportunity to improve their oral health, particularly in deprived areas.
Adding fluoride to the water looks like a quick fix. It is a very blunt instrument indeed and potentially a risky one, because we don't know what the long-term effects of fluoridation are.
It's not good enough to say “we have had consultations and a large number of people want fluoride in their water”. Because potentially many other people would be horrified, but they do not know about it.
A public debate needs to be held. The public does not have all the facts at its fingertips, so how can it make an informed decision?
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10:45 AM
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