Fluoride in Bedfordshire - Fluoridation argument summary

"It is an absolute tragedy in this day and age to have young children queuing up to have rotten teeth removed under anaesthetic. Studies have shown that water fluoridation is a safe, proven method of reducing tooth decay and putting the smiles back on our children's faces."
1. What about the pain and anguish of our children?
  
  Of all the arguments in favour of fluoridation, this one is the most difficult to deal with. Every parent wants to do what's best for their children. Certainly, as a dental professional it must be very distressing to operate on children for a condition which is so easily preventable by adopting good dietary habits. With the internet and a generally more aggressive media service, hitherto inaccessible material has been made easier to find, making us more informed, but typically more indecisive. So, just who do you believe on the fluoridation issue? Well, lets step back from the queue of soon-to-be anaesthetised children and take up the safety issue.
2. It's not safe!
  
  The fluoridation chemical hexafluorosilicic acid has never been tested on humans or animals for safety assessment. So with regard to safety, ask your dentist these questions:
  1. What is the maximum safe daily dose of fluoride considered to be?
  2. What is the therapeutic dose considered to be? (I.e. to reduce tooth decay.)
  3. How much do we get daily in Bedfordshire?
  The answer to the first 2 questions are fairly well established (though heavily disputed!) as 10 milligrams (mg) per day and 2mg per day. (Concentrations of 5 milligrams per litre (mg/l) and 1mg/l with the assumption that we drink 2 litres of water daily). What your dentist won't be able to tell you is the answer to the last question. In Bedfordshire, exactly how much fluoride you're getting depends on how thirsty you are, how much tea you drink, how much fish you like to eat, how long you bathe or shower for and all other total sources of exposure to fluoride. There is such a fine margin of safety between the two amounts, that it is entirely possible to exceed the daily limits and overdose on fluoride. Especially when the fluoride is concentrated in your food during cooking. Some scientists are even calling for a zero tolerance exposure level for fluoride, after studies have shown adverse health effects at 1mg/l. In short, fluoride safety has never been more in question than it is today. The health risks which have been associated with fluoride include:
  - cancer
  - osteoarthritis
  - osteoporosis
  - irritable bowel syndrome
  - hypothyroidism
  - skeletal fluorisis
  - dental fluorosis
  - reduced IQ in children
  - early onset of puberty
  - sperm abnormalities
  - gastrointestinal disorders
  - kidney stones
  - adverse interaction with aluminium and lead
  - stillbirth
  - Down's Syndrome
  - birth defects
  - increased infant mortality
  - allergies and intolerances
  It's a big list, but don't take it on faith. Take a look at the research that supports these findings, or take a look at our health risks summary. Categories of the population which are more at risk include:
  - the elderly
  - children
  - diabetics
  - those with kidney (renal) disease
  - those with calcium, magnesium or Vitamin C deficiency
  - those with cardiovascular disease
  During the 30 years of fluoridation in Bedfordshire, no testing has ever been conducted into the possible adverse health effects.
3. It's not proven either!
  
  Remarkably enough, in the fifty years of water fluoridation, not a single double-blind study has emerged which gives proof of lower tooth decay. In 2000, the University of York produced a report which was intended to be the last word on fluoridation. Despite the number of studies which have been conducted, Professor Trevor Sheldon, chairman of the Advisory Group stated:
  
  "The review team was surprised that in spite of the large number of studies carried out over several decades there is a dearth of reliable evidence with which to inform policy. Until high quality studies are undertaken providing more definite evidence, there will continue to be legitimate scientific controversy over the likely effects and costs of water fluoridation."
  
  Another follow-up statement added:
  
  We could discover no reliable good-quality evidence in the fluoridation literature world-wide. What we found suggested that fluoridation was likely to have a beneficial effect, but in fact the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.
  
  By contrast, there is evidence to suggest that tooth decay has been declining equally across the globe, in fluoridated and non-fluoridated areas. Studies have also shown that expected rises in tooth decay following cessation of fluoridation did not materialise. Click here for the story of Dr. John Colquhoun, a former fluoride advocate, who changed his mind on the subject. Another dentist, Dr. Hardy Limeback also had a very public change of mind.
4. Storing up trouble?
  
  It's a moot point as to whether dental fluorosis produces better smiles compared to tooth decay. Certainly, what we don't want to be doing as a nation is to attempt to put the smiles back on our childrens faces, only to exchange them for misery in later life with fluoride related health effects. There is an overwhelming body of evidence that points to the toxicity of fluoride both cumulatively and immediately. In this case, the precautionary principle should be applied. It should be taken out of the water and independently conducted research should be undertaken to examine all fluoride related health aspects. We shouldn't have to wait until the British Medical Association or the British Dental Association agree with what the toxicilogists have known for a long time. That fluoride is a potent neuro-toxin, capable of creating irreversible changes in brain chemistry, even at low doses. Read the affidavits (legal statements) of Dr.A.K.Susheela and Albert Schatz for two damning indictments of fluoride.
"Since all water contains fluoride, a trace element that is also present in soil, plants, many foods and fresh and sea water, fluoridation is really nothing but a process of adjusting natural levels to the optimum level for protection against tooth decay."
1. Like it's just natural man, right!?!
  
  Of all the arguments for fluoridation, this one is probably the most insidious. The first part of this statement is correct. Fluoride is naturally present in UK water, as calcium fluoride, at levels up to around 1.5mg/l. However, just because it's natural doesn't mean it's innocuous. Arsenic is another naturally occurring, put poisonous element, which must be filtered from water. Scientists in India have had years of experience in dealing with the adverse bone and skeletal health effects caused by high levels of naturally occurring fluoride in water. Typically the levels encountered are higher than the 1mg/litre advocated by the health authority, but once fluoride is in the water source, it becomes concentrated in foods cooked and prepared with water.
  
  Natural fluoride aside, the dosing chemical hexafluorosilicic acid is around 85 times more directly toxic than calcium fluoride, containing lead, arsenic and trace amounts of radioactive isotopes. It certainly isn't a natural substance, being a product of the super-phosphate industry. In July 2002, a report commissioned by The British Fluoridation Society purported to show that chemically, hexafluorosilicic acid (HA) is the same as calcium fluoride when dissolved in water to produce fluoride ions. This work was entirely theoretical and ignored existing empirical studies. In response, the National Pure Water Association printed a rebuttal of the paper by Myron J. Coplan, a chemical engineer. If the chemistry of hexafluorosilicic acid is so well understood, why did the Environmental Protection Agency of the USA issue a Request for Applications (RFA) to conduct research into the subject in June, 2002?
2. Just who calculated the optimum level?
  
  The original account of how the fluoride intakes were calculated seem to be one of bungling and negligence. Click here for an overview.
"Water fluoridation has been recognised by the United States' Centre for Disease Control (CDC) as one of the "Ten Greatest Public Health Achievements of the Twentieth Century". Water fluoridation benefits persons of all ages and socio-economic groups. It reduces the inequalities in caries experience based on socio-economic status, and therefore provides the greatest benefit to those who can least afford dental care. Although other products containing fluoride are available, water fluoridation remains the cheapest, most effective and socially equitable measure of achieving a community-wide reduction in dental caries."
1. A case of the Emperor's New Clothes?
  
  Any health intervention which is billed as one of the 'Ten Greatest Public Health Achievements of the Twentieth Century' should have an overwhelming body of evidence to support the statement. Unfortunately, no such body of evidence exists. In the USA you will struggle to find supporters to discuss the benefits of fluoridation in open debate. If we could change the wording to 'Public Health Relations...' then we'd support that. Everybody thinks that fluoride is fantastic until they do the research.
2. Does it reduce inequalities in dental health - who knows?
  
  The same follow up letter from the University of York review that clarified the benefits/disbenefits of fluoridation also had this to say:
  
  "Effectiveness of fluoridation in reducing inequalities in dental health across social groups - This evidence is weak, contradictory and unreliable"
  
  If you're poor, you're more likely to suffer from malnutrition which makes you more susceptible to the adverse health effects of fluoride. Click here to read the affidavit of Dr. Albert Schatz which documents the terrible effects of fluoridation in Chile on congenital birth defects and infant mortality.
3. Is it cheap?
  
  Well, if it was working as advertised, fluoridation could be regarded as cheap when compared with the cost of dental treatment required to 'fix' tooth decay. According to the Bedfordshire On Sunday, our health authority has spent £60,000 pounds over the last 2 years on fluoridation. Extrapolating that figure, means close to 1 million pounds has been flushed down the toilet over the last 30 years.
"The community dentistry statistics for Bedford show that we have half the tooth decay of unfluoridated Luton."
1. It figures, doesn't it?
  
  This one's an interesting argument and one we came across in discussion with the health authority. Take a look at the British Association for the Study of Community Dentistry (BASCD) data for 5 year olds in 2001/2002.
  
  Bedford is given an average Decayed Missing or Filled Teeth (DMFT) figure of 1.04. Now take a look at the figures produced by the British Dental Association (BDA) in their recently published 'league table' broken down by constituencies.
  
  Not only is Bedford mistakenly represented as unfluoridated (they're only getting a little ahead of themselves ;-), but the DMFT figure of 1.27 puts us LEVEL with Luton and a few other areas in this part of the country. The BDA say that this discrepancy arises when the BASCD source figures are adjusted to reflect constituency boundaries. Patrick Hall's constituency is Bedford and Kempston. Needless to say, the health authority weren't too pleased with the BDA when we pointed this out. They have a fluoridated milk scheme running at schools in Luton and would probably advise that Luton's water be fluoridated if allowed. So let's just underline this finding:
  
  According to the BDA's own figures Bedford, Mid-Beds and North-East Beds have the same prevalence of tooth decay as Luton (both North and South), and Bedfordshire is predominantly fluoridated, Luton is not. So, fluoridation simply isn't working in Bedfordshire.
"In a society where people come together for mutual benefit, it is a question of balancing the personal preferences of some individuals against the common good, arising from the lower levels of tooth decay that fluoridation would bring."

More to come soon...see the Cross Review on the ethics and legality of fluoridation for now.