Who is right in the fluoride debate?

AGAINST

JANE Jones is a campaigner against water fluoridation from the National Pure Water Association. She says:

PUBLIC health officials promote water fluoridation, allegedly to help "poor children who suffer from tooth decay". They claim that "hundreds of studies prove" that water fluoridation is safe and effective.

Most of the 40,000-odd published scientific papers on the health effects of fluoride are not about teeth. They show damage to bones and organs. Science has shown that about 50 per cent of the fluoride to which people are exposed is stored in the body.

Fluoride increases bone density but makes it more brittle. It is known to poison many enzymes and has profound effects on the thyroid gland. However, dental health officers dismiss all these studies as "flawed".

In 2000, the Government published the report of a "systematic scientific review" on water fluoridation. Fewer than 250 scientific papers were examined. All animal and biochemical studies were excluded from scrutiny. Despite this selectivity, all of the papers reviewed were reported to be of poor quality.

The review concluded that reduction in tooth decay -- if any -- is about 14.6 per cent. Furthermore, the scientific reviewers found that 48 per cent of people living in fluoridated areas develop dental fluorosis.

Only 10 per cent of UK drinking water is fluoridated. Therefore, "48 per cent" of people with dental fluorosis translates to almost three million victims.

Fluorosed teeth appear as stained or mottled. In moderate to severe cases, they become pitted and brittle. Health officials dismiss this permanent damage as "merely a cosmetic effect", or "a classic public health trade-off".

In 2000, Government spokesperson Baroness Hayman concurred that dental fluorosis is "a manifestation of systemic toxicity" -- the visible sign of fluoride poisoning.

There is another, more insidious consequence of dental fluorosis. Fluorosis, which appears as "dirty teeth", can seriously affect an individual's ability to interact and form relationships, leading to exclusion, loneliness and long-term depression.

Such conditions can precipitate anti-social attitudes which may, in turn, lead to criminal behaviour. Further studies have shown that unattractive teeth can severely impair people's employment choices and future prospects.

Dental fluorosis is foreseeable visible damage. The cost of cosmetic veneers is about £150 per tooth. The treatment must be repeated every few years and fluorosis victims must bear the full cost. The only people who profit are those who insist that fluoridation is safe and effective -- dentists.

FOR

MICHAEL A Lennon is Professor of Dental Public Health at the University of Liverpool School of Dentistry. He says:

CHILDREN'S dental health in the North-west is the worst in England, and severe tooth decay is a particular problem among our young children.

The dental health of Bolton children has not improved since 1987 and, by five years of age, over half have some decayed teeth. Indeed, one in seven have had at least one tooth extracted -- usually under general anaesthetic -- a nasty experience for all concerned.

Fluoridation of the water supplies in Greater Manchester would significantly reduce both the amount of tooth decay in children and its severity.

Importantly, it would drastically reduce the need for general anaesthetics for tooth extraction. In Birmingham, where water supplies have been fluoridated for almost 40 years, and Hartlepool, where water supplies are naturally fluoridated, children's teeth are very much healthier than Bolton children's.

A recent independent review of the scientific evidence showed that water fluoridation reduces the number of decayed teeth by, on average, 2.2 teeth per child, and increases by approximately 15 per cent the number of children with no tooth decay at all.

Improvements on such a scale would benefit the health of Bolton children enormously.

The review found no evidence of adverse effects on general health including no effects on bone health. It did highlight an increased risk of dental fluorosis -- mottling of the teeth. However, dental fluorosis is a cosmetic issue, not a health problem.

It is not as unsightly as tooth decay, does not affect general health or the function of the teeth, and is most common in its mildest forms which are barely visible, even to those affected.

For a small minority of people water fluoridation is a controversial issue. However, the Government, rightly, says no area would be expected to fluoridate without having undertaken a proper consultation that established that the measure was strongly supported locally.

Over 300 million people worldwide drink fluoridated water. The population of Hartlepool receive naturally fluoridated water. Elsewhere, the natural fluoride level is topped up. It is safe and effective, and the children of Bolton and elsewhere in the North-west deserve the benefits too.

We are now in an era of greater co-operation between health and local authorities. Now is the time for the new health authority, the new Primary Care Trust and Bolton Council to work together and engage the public in a properly informed debate so that the people can decide.

What do you think?

Michael A Lennon,

Professor of Dental Public Health,

University of Liverpool School of Dentistry, Liverpool, L69 3GN.

Tel: 0151 706 5230.

Fax: 0151 706 5845.

E-mail: malen@liv.ac.uk

THE CAMPAIGNERS

AGAINST:

Jane Jones,

Campaign Director,

National Pure Water Association,

12 Dennington Lane,

Wakefield, WF4 3ET.

www.npwa.freeserve.co.uk/dent-

al_fluorosis.html

WHAT are your views on fluoridation? Write with your views to: Letters to the Editor, Bolton, Evening News, Churchgate, Bolton, BL1 1DE, or email shughes@boltoneveningnews.co.uk

Dental Health and Water fluoridation

Here in the UK cities

such as Birmingham and Newcastle have had fluoridated supplies for almost 40 years. In the USA fluoridation has been practised since 1945. Well over 60 per cent of the US population drink fluoridated water, including major cities such as New York, Los Angeles, and Washington.