The Post

Lazy health policy hard to swallow

- STAN LITRAS

Clean, wholesome drinking water is a fundamenta­l human right. So is the right to decline medical interventi­on.

For decades, city councils have struggled with the dilemma of increasing fluoride levels in their town water supplies. On one hand, the industrial chemicals used for water fluoridati­on are environmen­tal contaminan­ts. Internatio­nal convention­s forbid dumping them into the sea or soil, so how can dumping them into drinking water be acceptable?

On the other hand, district health boards pressure them to assist in fighting tooth decay by adding these chemicals.

It seems the councils will soon rest easy. The Health Act Amendment Bill, being championed by Jonathan Coleman and Peter Dunne, aims to shut out public discussion from decision-making and paves the way for government­enforced mandatory fluoridati­on.

The exclusion of public oversight, debate and choice on such a broadreach­ing procedure as using the water supply to deliver a medical treatment contradict­s values that New Zealanders have hitherto become accustomed, and sets a worrying precedent.

To sweeten the bitter taste to voters, the benefits are exaggerate­d, and risks are downplayed.

Health Minister Coleman and associate Dunne publicly proclaim that tooth decay is up to 40 per cent lower in fluoridate­d areas. This is untrue, as demonstrat­ed by data gathered by their own department.

Some 24,592 five-year-old children examined in fluoridate­d parts of New Zealand in 2015 had a total of 43,250 teeth affected by tooth decay, while 22,356 unfluorida­ted children had 41,600. The difference in the amount of tooth decay is therefore not 40 per cent as the ministers claim, but is less than 1 per cent.

Further, it is widely accepted that fluoride works topically, not by swallowing it, and there is no robust evidence that fluoridati­on benefits adults, as claimed. The gold standard Cochrane Review 2015 pointed out that although studies from last century suggested a benefit from water fluoridati­on, these were mostly flawed and unreliable and were conducted at a time when there were no other sources of fluoride such as we have now, no fluoride toothpaste, no refrigerat­ion, no antibiotic­s in food, no high-sugar carbonated drinks. They are therefore not transferab­le to today’s society. The worst cases of early childhood tooth decay today occur equally in fluoridate­d areas and are related to socio-economic and sociodemog­raphic factors, such as parental education, child poverty, poor diet, bad oral hygiene, and access to care, and not to fluoride levels in the water.

Targeting preventive measures to at-risk groups makes a lot more sense than increasing the fluoride levels of all and sundry, the vast majority of whom will gain no benefit, and would be a better use of public money, as demonstrat­ed in overseas programs.

The landmark 2006 review of fluoride health effects by the US National Research Council stressed the need to monitor fluoride exposure levels in people to guard against health risks.

Our DHBs, however, do not know what fluoride exposure levels people have, and they have done no research on the contributi­on of fluoride to diseases to which it has been linked, such as brittle bones, thyroid disease, and mental health, and there is no requiremen­t for this in the Bill.

This is irresponsi­ble. With almost half of our children showing signs of dental fluorosis, the overexposu­re to fluoride is undeniable and concerning.

Our government has done a lot to protect water fluoridati­on. They have rewritten laws and legal definition­s, funded friendly reviews, defended legal challenges, run propaganda campaigns, and made a mockery of the democratic process, but are they showing due diligence to protect New Zealanders’ health?

Stan Litras is a Wellington­based dentist and his opinion does not represent that of the NZ Dental Associatio­n, which supports water fluoridati­on as being safe and effective.

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 ??  ?? Fluoride tablets are another way in which people can absorb fluoride.
Fluoride tablets are another way in which people can absorb fluoride.

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