Fluoride: Drinking Water

Department of Health written question – answered on 21st September 2015.

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Photo of Earl Baldwin of Bewdley Earl Baldwin of Bewdley Crossbench

To ask Her Majesty’s Government what assessment they have made of the statement in the 2015 systematic Cochrane review Water fluoridation for the prevention of dental caries that the authors’ confidence in evaluating fluoridation’s effectiveness was limited by there being "very little contemporary evidence, meeting the review’s inclusion criteria", and by "the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles".

Photo of Lord Prior of Brampton Lord Prior of Brampton The Parliamentary Under-Secretary of State, Department of Health

The results of the 2015 ‘Cochrane ReviewWater fluoridation for the prevention of dental caries’, Iheozor-Ejiofor et al, Feb 2015 are broadly consistent with those from other systematic reviews conducted over the past 15 years in concluding that this public health measure is, as the Cochrane authors state, “effective at reducing levels of tooth decay in both children’s baby and permanent teeth.”

The Cochrane review used specific and relatively narrow criteria requiring that studies include baseline measures of dental caries in two communities, one of which then introduced fluoridation within three years. This approach had the consequence of excluding numerous studies conducted over the past 25 years which compared dental caries levels in fluoridated and non-fluoridated communities. The Cochrane reviewers acknowledge in their report that there may be concerns regarding the exclusion of these studies from their review.

The Cochrane review analysed studies conducted in different ways at different times in different places, finding consistent reductions in levels of dental caries following the introduction of fluoridation. The term ‘bias’ used in the Cochrane review has a specific scientific meaning relating to controlling for other factors such as dietary habits that might have affected the levels of dental caries in the populations studied. The reviewers recognise that this bias “may occur in either direction”.

Relatively recent studies which did not meet the reviewer’s specific inclusion criteria have continued to find substantial dental benefits of water fluoridation. Public Health England’s (PHE) recent Monitoring Report (2014) looked at fluoridated and non-fluoridated communities in England and found that communities served by water fluoridation schemes continue to show lower levels of tooth decay.

A copy of PHE’s report is attached.

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Paul McEvoy
Posted on 22 Sep 2015 11:44 am (Report this annotation)

The most important reason to end fluoridation is that it is simply not a safe practice, particularly for those who have health conditions that render them vulnerable to fluoride’s toxic effects.

First, there is no dispute that fluoridation is causing millions of children to develop dental fluorosis, a discoloration of the teeth that is caused by excessive fluoride intake. Scientists from the Centers for Disease Control have even acknowledged that fluoridation is causing “cosmetically objectionable” fluorosis on children’s front teeth–an effect that can cause children embarrassment and anxiety at an age when physical appearance is the single most important predictor of self-esteem.

Second, it is known that fluoridated water caused severe bone disease in dialysis patients up until the late 1970s (prior to dialysis units filtering fluoride). While dialysis units now filter out the fluoride, research shows that current fluoride exposures are still resulting in dangerously high bone fluoride levels in dialysis patients and patients with other advanced forms of kidney disease. It is unethical to compromise the health of some members in a population to obtain a purported benefit for another — particularly in the absence of these vulnerable members’ knowing consent.

And, finally, a growing body of evidence reasonably indicates that fluoridated water, in addition to other sources of daily fluoride exposure, can cause or contribute to a range of serious effects, including arthritis, damage to the developing brain, reduced thyroid function, and possibly osteosarcoma (bone cancer) in adolescent males.