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Posted on 30 Jul 2009 12:55 pm

Only if fluoridation practice were demonstrably entirely safe and self-evidently dentally - and thus economically - effective might it be considered to be 'worthwhile public dental health policy' - and Government might conceivably then be justified in legislating so as to override people's right to refuse a form of compulsory medication via the public water supply that they did not want - most probably because they had heard other views from independent sources, whose statements they felt very strongly were both cogent and reliable.

To clarify these points:

re Safety: York CRD (2000) stated that, in view of the paucity of high quality research into all of the possible negative health effects identified, they could come to no clear conclusion about any specific adverse health effect. They then recommended that high quality research must be conducted in a number of specific areas before any Government could justifiably recommend fluoridation practice as 'safe'. Since then the U.S. National Research Council Report (2006) has been published, detailing high quality evidence of harmful effects (including evidence from sources that were not even considered by York). These harmful effects would certainly apply to specific vulnerable sub-groups of any population if they were exposed to artificial fluoridion at 1 ppm. This means that the best available scientific evidence does not find mass fluoridation to be 'safe'. The NHS relies exclusively for its views regarding safety on periodic 'expert reviews'- conducted under the auspices of public health dentists, who are clearly insufficiently qualified even to appreciate the quality of all the evidence they choose either to review, or to ignore. Such biased reviews are not worth the paper they are written on in the context of any serious public debate of this key issue of safety.

re dental effectiveness: York CRD could find no high quality evidence, but only evidence of moderate quality for any possible beneficial effects of fluoridation in reducing both the prevalence and the subsequent rates of change of dmft/DMFT carious decay statistics. But the most recent studies identified were notable principally for reporting, accurately, the derisory dental benefits that can currently be derived in the countries under mass fluoridation, now that far more effective topical fluoride dental preparations are in almost universal use throughout all fluoridated and non-fluoridated populations alike.

This data also shows clearly that artificial fluoridation schemes, costly to set up, to maintain and to run, cannot possibly be considered 'cost-effective' under the conditions that prevail today. Most of the caries statistics used by public health dentists in their attempts to make a viable case for further fluoridation schemes, as are now happening across the country, were ruled out of consideration as reliable evidence of benefit by York, simply because they signally fail to consider all the relevant confounding factors. Evidently, then, there is no reliable evidence today for any worthwhile dental health benefits across any child or any adult population. To prevent socially deprived families from succumbing to 'runaway caries' it is clearly necessary to target such families with sound advice, effective preventive measures and sufficiently early dental treatments as required. This properly funded approach has been shown to cost far less than the inevitably poorly targeted fluoridation schemes that have been recommended largely for the specific problem of child populations suffering from extreme social deprivation.

Conclusions: any public health official who today declares that fluoridation really is 'safe and very effective' and that 'it also represents the best available use of scarce NHS dental funds' would find it extraordinarily difficult to explain under oath to a Court how he/she could ever have become genuinely convinced that these statements, and many more similar ones, were indeed truthful.

The National Pure Water Association is committed to achieving the total dismantling of all U.K. Government legislation that is currently in place to support the propagation of mass fluoridation - and it will, indeed, go to Court if necessary in order to obtain justice, under the effective law of the land, for every individual member of the European Union who happens currently to reside in England, Wales or Northern Ireland.

Ian E Packington MA Cert Tox
Science Adviser to NPWA

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