Fluoridation

House of Lords written question – answered on 28th October 2013.

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Photo of Earl Baldwin of Bewdley Earl Baldwin of Bewdley Crossbench

To ask Her Majesty’s Government, in the light of the finding by the NHS Centre for Reviews and Dissemination at the University of York in its 2000 report A Systematic Review of Water Fluoridation that the evidence suggested a median of 14.6 per cent reduction in children with tooth decay in areas fluoridated at 1 part per million, why the NHS Choices website under ‘Fluoride’ (1) cites a single study reporting that fluoridated children “had nearly 60 per cent less tooth decay”, and (2) makes no reference to the York report.

To ask Her Majesty’s Government, in the light of the Authors’ reply in the British Medical Journal on 16 June 2001 about the 2000 University of York report on water fluoridation that “We have been assiduous in our paper…not to convey a message of no evidence of harm”, whether they will ensure that the NHS Choices website under “Fluoride” no longer claims that fluoridated water and toothpaste “do not cause any harmful side effects to a person’s overall health”.

To ask Her Majesty’s Government, in the light of the finding by the 2000 University of York report on water fluoridation that 48 per cent of populations fluoridated at 1 part per million were affected by dental fluorosis and 12.5 per cent by fluorosis of aesthetic concern, and that geographical location was not significantly associated with those figures, whether they will ensure that the NHS Choices website under “Do fluoride levels in cheap tea pose a health risk?” no longer states that “fluorosis…is rare in the UK”.

To ask Her Majesty’s Government, in the light of the statement in Department of Health Report on Health and Social Subjects 41 on dietary reference values that “No essential function for fluoride (F) has been proven in humans”, whether they will ensure that the NHS Choices website under “Do fluoride levels in cheap tea pose a health risk?” no longer states that “Fluoride is a mineral that is needed for healthy teeth”, and that “fluoride is an essential micronutrient, needed to prevent dental decay”.

To ask Her Majesty’s Government, further to the Written Answers by Lord Hunt of Kings Heath on 12 February 2001 (WA 16) and by Earl Howe on 15 September 2011 (WA 87–8), whether the promotional role of the British Fluoridation Society which is recommended as a source of advice on the NHS Choices website under “Fluoride” makes it a suitable body to provide objective information on the claimed dental benefits of fluoride.

Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health

The NHS Choices website section on fluoride is due for review in January 2014 and we have asked Public Health England (PHE) to review the information and make recommendations by 15 December. This will include ensuring that the information for the public is clear and based on evidence.

Pending that review, we are advised by PHE that there is no credible scientific evidence that water fluoridation at 1 part per million, the target level for water fluoridation schemes in England, or fluoridated toothpaste, used as such, is a cause of general ill health.

Regarding dental fluorosis, we are advised by PHE of a recent research by McGrady and co-workers, published in BMC Public Health 2012, comparing levels of dental fluorosis in fluoridated Newcastle and unfluoridated Manchester which showed that 0.1% of children in Newcastle had severe fluorosis compared with 0.2% in Manchester; the prevalence of moderate fluorosis was 1% in Newcastle compared to 0% in Manchester, these being far lower levels than those suggested by the York review.

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Annotations

Paul McEvoy
Posted on 29 Oct 2013 7:47 pm (Report this annotation)

"Sodium Fluoride kills enzymes, it should not be in the human body. Sodium fluoride makes people sick, sodium fluoride kills people." James Sumner, Nobel Prize winner for enzyme chemistry.

IAN PACKINGTON
Posted on 7 Nov 2013 10:44 am (Report this annotation)

Unlike more concentrated oral fluoride vehicles (e.g. toothpastes, mouthwashes and varnishes) fluoridated water has never been shown unequivocally to reduce the numbers of enamel-penetrating lesions that will eventually emerge around the teeth of a caries-prone subject. Fluoridated water, acting directly on the teeth, can merely delay - by variable amounts - the moment when dentinal caries has to be treated; thus necessary treatment costs will not be reduced by fluoridation, though age-based comparisons of decay prevalence and teeth already treated will inevitably reflect the temporarily less advanced carious situation promoted across any given population by reduced rates of enamel penetration. Against this lack of any strictly meaningful caries benefit one has to set the certainty that fluoridated water will significantly increase the incidence of unsightly dental fluorosis - needing expensive remedial treatments in due course.

Dental caries is a bacterially initiated disease, whose elimination has so far defied all research initiatives, including the development of effective oral vaccines. Today caries-preventive measures can best be maintained by appropriate diet, together with personal and professional management of the oral environment, and by the targeting of effective early and ongoing help to prevent early and disastrous caries development in families in disadvantaged communities. Contrary to the misleading promotional activities of dental public health apologists under the aegis of the UK Department of Health, fluoridation must be seen as primarily 'a tooth-damaging mass medical intervention unjustifiably imposed in the absence of informed public consent'. It always was a significantly harmful practice, and it has no place at all in a contemporary oral health context, where genuinely effective and cost-effective anticaries measures could and should already be in place for the entire population.

Meanwhile the evidence of serious harm to human health from lifelong consumption of fluoridated drinking water has continued to accumulate. Fluoride ions adversely affect vital cell functions - and reduce the survival times of normal cells - in a wide variety of ways, to an extent determined by the levels at which they are present in specific tissues. Artificial fluoridation ensures that tissue fluoride levels are raised lifelong to average levels significantly greater than via appropriate use of fluoridated dental products. These levels lie about halfway between the typical levels found in unfluoridated areas and those at which evidence for general ill health is undeniably present in many parts of the world - including India and China - where it is manifested as both skeletal and non-skeletal fluorosis (a tissue-wasting condition that can be effectively reversed by removal of all fluoride sources followed up with sound nutritional support). Skeletal fluorosis - abnormal and crippling calcifications of bone and connective tissues - is irreversible. At lower exposure levels the excess cytoplasmic harm attributable to fluoride ions must continue to accumulate, but it remains subclinical; no overt disease manifestations linked exclusively to fluoride toxicity emerge, as in India, that do undeniably harm a significant proportion of the exposed population. Nevertheless epidemiological comparisons of health outcomes in fluoridated populations c.f. unfluoridated ones have always made uncomfortable reading. The significance of such comparisons has invariably been denied by fluoridation promoters. [The practice has always relied on dogmatic assertions concerning the absence of any sufficiently clearcut and statistically significant evidence for the augmenting of severe harms to significant numbers of people exposed lifelong to artificial fluoridation at 1 ppm].

Recent lines of research appear to have converged in what may finally prove to be decisive in establishing a mechanism of linked cytoplasmic harm that underlies the accumulation of chronic autoinflammatory diseases - including cardiovascular disease, neurodegenerative disease (both Parkinson's and Alzheimer's) and cancers of all kinds. Epidemiological comparisons between the Republic of Ireland (up to 70% fluoridated since 1960) Northern Ireland, the UK (10%) and other EU states [1] have revealed startling excesses of many chronic disease states, and of overall age-related mortality, in the Republic - linked with social deprivation (and poor nutritional status) and with water softness (which increases the harm due to fluoridation). Although careful monitoring for deteriorating communal health was part of the originally agreed fluoridation protocol, this has never been undertaken by the relevant authorities in the Irish Republic.

As stated above, this recently compiled epidemiological evidence of harm coincides with a major clarification of the mechanisms governing cytoplasmic oxidative stress, chronic tissue inflammation and the rate of emergence of degenerative tissue diseases [2]. Fluoride ion-initiated oxidative stress in mitochondria at 2-5+ ppm directly causes chronic non-skeletal fluorosis; at all lower levels fluoride ions continue to generate reactive free radicals [ROS] at numerous sites in and around cells where oxygen is processed - but apparently relatively harmlessly while cellular antioxidant status remains uncompromised. Now we know that mitochondrial ROS, stimulated by all external ROS generation, will act as the key intermediary signalling species for the induction of proinflammatory cytokines; a vicious feedback cycle can then take hold in specific vulnerable tissues, leading to cumulative tissue degradation and chronic degenerative disease states. Thus it is no mere coincidence that fluoridation at 1 ppm is demonstrably linked with the earlier and more frequent emergence of so many chronic and ultimately fatal disease conditions. In 1978 John Yiamouyiannis named fluoride as 'the aging factor'- but it seems that its inherent capacity to augment severe and ultimately fatal tissue and organ damage has finally been unmasked.

Israel's Supreme Court recently announced its decision to terminate all fluoridation schemes in 2014, citing concerns about harm to health and lack of dental effectiveness. No doubt Israel remains under intense USPHS pressure to reverse this decision.

It is regrettable that the UK Department of Health still sees its primary duty as the obstinate promotion of fluoridation practice, in strict conformity with what was originally the USPHS-imposed control over Parliamentary freedom to remove fluoridation practice from the UK statutes when it was first introduced into the UK, under Enoch Powell's tenure as Secretary of State for Health.

Ian E Packington MA (Oxon) Cert Tox (Barts)
Science Adviser to National Pure Water Association

[1] 'Public Health Investigation of Epidemiological Data on Disease and Mortality in Ireland related to Water Fluoridation and Fluoride Exposure'
Report for the Government of Ireland submitted by Declan Waugh BSc CEnv MICWEM MIEMA MCIWM March 2013 (159 pp)

[2] Xinjuan Li, Pu Fang et al 'Targeting mitochondrial reactive oxygen species as novel therapy for inflammatory diseases and cancers' Journal of Hematology and Oncology 2013;6:1-19 [open access] http://www.jhoonline.org/content/6/1/19