Thursday, February 05, 2009

Water fluoridation for Bristol??

In late January Bernard J Seward, a campaigner from the National Pure Water Association and the Safe Water Campaign for Avon, Gloucester and Wiltshire had a letter in the local paper about a possible public consultation in the Bristol area on putting fluoride in all our drinking water. It seems that there is a drive for more water fluoridation from central government. There are therefore understandable concerns that consultations on the issue would not be genuinely open as to the outcome.

I’ve spent a few days looking from all angles at as much information as I can on the issue. There are, however, significant problems obtaining a decent amount of high quality research showing that putting fluoride in drinking water safely and effectively does what it is supposed to do – reduce tooth decay. Available research is often categorised as of only moderate quality because bias and lack of control are evident and analysis is lacking. No clinical trials have been conducted. No license obtained for fluoridated water. Why not? Fluoridated water aims to create bodily changes to fight tooth decay does it not?

Other aspects of the issue defy good scientific practice too. The dose of fluoridated water received by each person depends on the amount of water we drink. Since we all drink different amounts the dose is highly variable – and will be received over a long period of time. Further, the people receiving the dose are highly variable too and unlike being prescribed a treatment by a GP, wont be seen beforehand and wont have their medical history checked. The whole scenario lacks control.

Most of Europe has seen falling rates of tooth decay for several decades – without a policy of widespread water fluoridation. Fluoride is available by choice in toothpaste. Salt containing fluoride could also be made widely available alongside non-fluoridated salt. Those who don’t want to consume fluoride, or have no need to, have a choice now but obviously cannot choose not to drink water and fluoridation is not essential to supplying safe water unlike chlorination to kill bacteria!! If all our drinking water was fluoridated they would therefore be consuming something designed to create bodily changes without their consent. It is the norm in our society to consent to treatment and we should stay consistent with this.

There is no substitute for regular dental check-ups where all sorts of medical issues can be covered. One wonders, given the difficulties people have experienced in recent years with getting an NHS dentist, whether the focus should be there and not with water fluoridation!!

The maximum concentration of fluoride currently allowed in our water is 1.5 mg/l. Any water fluoridation system would have to stay below this legal limit or perhaps an even lower limit would be set. There is always going to be debate over what ‘safe’ levels are. Its clear that the substances used to fluoridate water (sodium fluoride, fluorosilicic acid and sodium fluorosilicate) are, as pure substances, most unpleasant to say the least. That fluorosilicic acid is a by-product from phosphate fertiliser manufacturing hardly adds to the case for its use! Overfeeding of such substances into drinking water has caused serious health problems, as at Hooper Bay in Alaska in the 1990’s, where equipment and human failure resulted in 1 death and 295 cases of fluoride poisoning(details here). Overfeed precautions and plans for defluoridation if limits are exceeded are of course not needed if you don’t fluoridate in the first place!

Key local and regional decision makers and further information:

I've written to Dr Hugh Annett, Director of Public Health for NHS Bristol and Bristol City Council via , and the Strategic Health Authority via on this issue and hope others will too.