Republican News · Thursday 5 September 2002

Not the F in water again!

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After recent articles in this paper by opponents of fluoride in our drinking water, STIOFáN LONG (Sinn Féin local representative, Balmoral) presents the case for the defence

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Fluoride in the water

From the rather one-sided debate that has been carried out in An Phoblacht so far, one would wonder how any sane person would want a substance that kills and cripples untold numbers, and which is only in the water because of an evil combination of scientific ignorance, multinational greed, and politicians' fear of being proved wrong. Well, the reason why many people do support the addition of fluoride to our water supplies is that the evidence suggests overwhelmingly that it does us good, and the good that it does us far exceeds any harm that it might cause.

Is fluoride harmful?

There isn't room here to answer every claim that antifluoridationists make about the unhealthy consequences of drinking fluoride. So let me take one example - that it causes cancer. This claim first emerged in 1977 when two antifluoridation chemists asserted in a journal one of them edited that fluoride was responsible for 25,000 excess cancer deaths each year. The findings and methods of these chemists were faulted and no one has since been able to repeat the results they got. Since then there have been over 50 peer-reviewed studies, none of which have substantiated their claim. In 50 years of scientific examination of water fluoridation, NO relationship between fluoride and cancer has been shown.

The US National Cancer Institute (NCI) investigated 2.2 million cancer deaths over a 36-year period in a review of all available scientific studies on the health of populations with and without fluoridated water supplies, and could find no link. The NCI's findings have been verified by the International Agency for Research in Cancer, the US Environmental Protection Agency and the National Research Council. It is hard to see what more could be done to demonstrate that the link does not exist, yet that seems to make no difference to those who oppose fluoride in water, who continue to repeat the claim with a confidence that is just bewildering.

Nor is it just a matter of there being no link to cancer. Another frequent claim is that fluoride causes osteoporosis - brittle bones. A systematic review commissioned by the British Department of Health of no fewer than 29 studies found no association between fluoride and bone fractures. Once again, the statements made by antifluoridationists simply do not stand up to scrutiny. The same kind of refutation could be made for any of the other diseases claimed to be caused by fluoride.

So is there nothing detrimental about fluoride? Well, there is; it can cause what is known as fluorosis, which is a buildup of excess fluoride in the teeth that can be seen in markings on the teeth. However, except in very rare cases where this may lead the enamel to become brittle, fluorosis is simply a cosmetic problem. It does not have any effect on the function of teeth, nor does it endanger the continued existence of the tooth. The same cannot be said of dental caries, or of tooth decay.

Is fluoride beneficial?

Once again, if we were to take antiflouridation arguments at face value, it would seem that there are no benefits whatsoever to adding fluoride to the water. Let us again look at the evidence. This time we can take it from a systematic review of the up-to-date expert scientific evidence commissioned by the British Chief Medical Officer and carried out by the University of York's Centre for Reviews and Dissemination. A huge number of studies were looked at, and these were independently quality controlled by two reviewers, their results being checked by a third. Two hundred and fourteen studies were deemed of sufficient quality to be included in the review.

The reviewers were asked to use the data to answer a number of questions. They were asked what were the effects on tooth decay of putting fluoride in the water. Their answer was very clear: fluoridation of drinking water reduces the prevalence of tooth decay.

In addition, the review found evidence that, even where people had access to alternative supplies of fluoride, such as in toothpaste, there were still beneficial effects from fluoridation of water. There was also evidence that fluoride in the water reduces inequalities in dental health across social classes. So, fluoride does at least two beneficial things.

First, it helps stop our kids' teeth going rotten (it only works on children's teeth). Second, it helps offset disadvantages experienced by working class kids that relate to their diet and the affordability of dental care products.

Freedom of choice?

Those against fluoride are correct when they point out that if it is in the water, people have little choice whether they take it or not. This objection is a politically significant one which republicans need to take seriously. Are we in support of mass medication or not?

However, when considering this problem, we should approach it from the best evidence available, and not on the basis of groundless conspiracy theories. Some of the best evidence has been outlined above, and it is on that basis that we should proceed. Thus, we need to ask whether or not the evident health benefits of fluoride outweigh the curtailment of individual choice that putting it in the water involves.

Are we prepared to allow our children to suffer the miseries of tooth decay, fillings and tooth extraction in order to have that freedom of choice?