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City blazes a trail in fluoride consultation

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Southampton will be the first area in the UK to seek the public's views on adding flouride to their tap water since Health Minister Alan Johnson's ‘fluoridation for all' proposal in February.

Health chiefs in the city are to begin consultation next month.

The move is in light of high levels of tooth decay there and coincides with the release of shocking pictures of children's rotten teeth by the city's Primary Care Trust (PCT) in a last-ditch attempt to turn around the city's poor oral health.

However, anti-fluoride campaigners are against the proposal, arguing that excessive fluoride has links with bone cancer and brittle bone disease as well as dental fluorosis that causes discolouring of the teeth and pitting of enamel.

The ‘tooth decay' photos – taken by local dentists – show the mouths of children whose teeth are filled with blackened stumps of decaying and diseased teeth.

And it's the alarmingly high number of infants with teeth in this state that are driving moves to add the fluoride.

Figures show that on average, five-year old children from Southampton have more than twice as many teeth affected by decay as those from fluoridated South Birmingham – and around three times more than those from fluoridated South Staffordshire, who have the best dental health in the country.

Efforts by Southampton City PCT to improve dental health via education and other initiatives, such as tooth-brushing schemes, have failed to make an impact.

Dr Andrew Mortimore, Public Health Director for Southampton City Primary Care Trust (PCT) says: ‘We are very pleased that following research into the feasibility and cost of water fluoridation, South Central Strategic Health Authority (SHA) have decided to plan a public consultation the outcome of which could significantly help improve the dental health of local people.

‘Southampton City PCT believes water fluoridation is the most effective way of reducing the large numbers of tooth fillings and extractions currently needed by children in Southampton.'

He adds: ‘Local dental health surveys show that oral health is poor with 42% of the City's children experiencing dental decay by the age of five.

‘This is clearly unacceptable when dental decay is a preventable disease. Everyone drinking fluoridated water – including children, adults and the elderly – will begin to benefit as soon as fluoridation is started and measurable benefits would be apparent in about five years.'

At present, the natural fluoride level in the city's water is too low to provide any protection to teeth.
However, if the fluoride is topped up to one part of fluoride per million parts of water, studies suggest that the average child is likely to have two fewer decayed teeth and that about 15% more children would be totally free from tooth decay.

Public consultation on a possible Southampton fluoridation scheme will last for three months.

No decisions will be made by the SHA until there is a thorough independent evaluation of the responses.

In February, Health Secretary Alan Johnson called for fluoride to be added to Britain's water supplies – backed by the British Dental Association (BDA).
But John Spottiswoode, chair of the pressure group Hampshire Against Fluoridation says: ‘I continue to be amazed at the one-sided way that people like the Health Secretary put the evidence on water fluoridation.

‘He quotes Birmingham as a good example of the effects of fluoridation. Well he actually knows that the best areas for tooth health in the UK are not fluoridated at all, and this situation applies in every country around the world. In fact, non-fluoridated Hampshire is also one of the best areas in England.

He adds: ‘OK, there are always some worse spots in cities, but use education to deal with it, not immoral mass medication with a highly toxic product.'

The government, however, sees fluoridation as an ‘effective and relatively easy way' to reduce tooth decay among children.

And the BDA adds weight to their proposal, saying that targeted water fluoridation helps fight against tooth decay, especially among poorer children.

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Surely the dental profession must be aware of the findings of the York Review. I contacted the York Review team to ask what the 15% figure meant exactly, and was told that the variation in results of the mediocre to poor studies that were all the Review found to exist meant that the figure is not accurate. The Review also found very little evidence to show that water fluoridation affected social inequalities in dental health, and were concerned at levels of fluorosis. They also dismissed the study/studies showing that the levels of dental health in Birmingham were as a result of water fluoridation.
Because of their concerns about the effect of fluoride chemicals on kidneys and the endocrine system, the NRC Panel recommended that the Maximum Contaminant Level Goal (MCLG) of fluoride in water, should be set below 2, and then a margin of safety should be applied. For variations in the human population, and to protect the most vulnerable, a margin of safety of at least 10 should be applied, which should bring the MCLG down to 0.2 or 0.2ppm.
Why has the dental profession been brainwashed into this insane position of pushing for our water to be contaminated. What would happen to the career of a dentist who opposed water fluoridation?

Posted by rlsm.taylor@talktalk.net 25/6/08 at 16:35

Nothing would happen to the 'career' of a dentist (certainly a principal), because no such 'career' in General Dental Practice really exists. Despite the efforts of FGDP(UK) - of which I am member, BTW. Studies in fluoridation now difficult as so many people use fluoride toothpaste. It's been added to the water up here in the N.E since 1969, and of course many places have levels naturally higher than 1ppm anyway. Drink tea? A cup of tea is just short of 100ppm 'fluoride chemicals'. Why not take 'chlorine chemicals' out of the water as well? (Nasty stuff, chlorine). We'd all start dropping down with cholera etc, but never mind......a least the water wouldn't be 'contaminated' by any nasty chemicals, would it now?

Posted by drstephenmorris 26/6/08 at 00:26

Tea of course has nowhere near 100ppm of fluoride and varies from under 2ppm to 8ppm depending on the tea. A problem of using York's average figure is that more recent studies show less benefit - mainly due to the use of fluoride toothpaste which is more effective in preventing tooth decay than water fluridation - in fact good oral hygiene with or without fluoride is more efffective than water fluoridation. Water fluoridation in the USA has not solved dental decay and poor oral health is still the biggest health problem for children with rates of dental decay reaching 80% of children in some communities fluoridated for many years. At the same time levels of dental fluorosis have increased by 20% over recent years. No I would not take chlorine out as it is essential for combatting bacteria in water but water without chlorine from natural well sources is so much better and unlike chlorinated water does not irritate my skin. Flouride is not necessary to make water ready for drinking. There is also increasing evidence of health problems from osteosarcoma to endocrine problems.

As for the consultation in Southampton this has been a bit of a sham with very poor information, an SHA taking a pro fluoridation standpoint in its literature when it is supposed to be neutral and producing material that contains factuual errors. In the meantime the PCT is spending £1000s promoting fluoridation, the economic evaluation commisioned by the SHA is virtually useless as it underestimates costs, over estimates benefits, overestimates cost savings and uses data for a population different to that being fluoridated. If consultations are to be undertaken about water fluoridation I am afraid that the South Central SHA has not provided a good example of how this should be done. This has all cost huge amounts of NHS money that could be better spoent on improving dental services in Southampton for under 5s - mainly under 5s as the caries rates for 11 year olds are about the English average.

Posted by ospika 17/10/08 at 22:52