The Northland Age - - Opinion - ROSS FORBES Kerik­eri

flu­o­ri­dat­ing com­mu­nity wa­ter sup­plies is an un­eco­nomic way of im­prov­ing the oral health of a pop­u­la­tion.

In its re­cently re­leased Oral Health Im­prove­ment Plan, the Scot­tish govern­ment states that although wa­ter flu­o­ri­da­tion could make a pos­i­tive con­tri­bu­tion to im­prove­ments in oral health, the prac­ti­cal­i­ties of im­ple­ment­ing it de­ter­mine that al­ter­na­tive solutions are more achiev­able.

The lat­est oral health statis­tics from the New Zealand school dental ser­vice for 12-year-olds (2016) show sta­tis­ti­cally in­signif­i­cant dif­fer­ences be­tween flu­o­ri­dated and non-flu­o­ri­dated co­horts.

The 26,207 chil­dren flu­o­ri­dated were 64.29 per cent caries-free with a mean of 0.80 de­cayed miss­ing or filled teeth (dmft), and the 21,120 non-flu­o­ri­dated chil­dren 60.58 per cent caries-free with a mean of 0.97 dmft.

That is less than four per cent dif­fer­ence in caries-free and with de­cayed, miss­ing or filled teeth the dif­fer­ence is less than one fifth of a tooth.

Flu­o­ri­da­tion is hugely waste­ful, as most flu­o­ri­dated wa­ter goes straight down drains. Only a small frac­tion of one per cent is swal­lowed by peo­ple, and from a value for tax­payer or ratepayer view­point it is most con­cern­ing that the cur­rent coali­tion govern­ment has not with­drawn the in­iq­ui­tous Health (Flu­o­ri­da­tion of Drink­ing Wa­ter) Amend­ment Bill, which will em­power district health boards to di­rect ter­ri­to­rial au­thor­i­ties to flu­o­ri­date or not flu­o­ri­date drink­ing wa­ter sup­plies in their ar­eas.

The po­ten­tial spend of tens of mil­lions of tax­payer and/or ratepayer dol­lars on na­tion­wide im­ple­men­ta­tion and on­go­ing man­age­ment of flu­o­ri­da­tion over, say, a 20-year hori­zon, would be an un­con­scionable di­ver­sion of scarce health re­sources.

A far less costly, more ef­fec­tive and proven ap­proach is ex­pen­di­ture on in­di­vid­ual treat­ment, per­sis­tent early child­hood and pri­mary school oral health ed­u­ca­tion, and on­go­ing pub­lic­ity on the bad health con­se­quences of excessive su­gar con­sump­tion.

To ob­vi­ate sig­nif­i­cant mis­al­lo­ca­tion of pub­lic funds, govern­ment must with­draw the Health (Flu­o­ri­da­tion of Drink­ing Wa­ter) Amend­ment Bill from Par­lia­ment’s or­der pa­per.

In com­ment­ing on the ear­lier cited Cochrane Col­lab­o­ra­tion re­port, Trevor Shel­don, who chaired the ad­vi­sory group for the sys­tem­atic re­view on the ef­fects of wa­ter flu­o­ri­da­tion, com­monly known as the York Re­view 2000 (pub­lished in the ‘Bri­tish Med­i­cal Journal),’ says that if flu­o­ri­da­tion were to be sub­mit­ted anew for ap­proval to­day no­body would even think about it due to the shoddy ev­i­dence of ef­fec­tive­ness and ob­vi­ous down­side of flu­o­ro­sis.

He also said that when a pub­lic health in­ter­ven­tion is ap­plied to ev­ery­body, the bur­den of ev­i­dence to know that peo­ple are likely to ben­e­fit and not to be harmed is much higher, since peo­ple can’t choose.

It is clear, in my view, that cur­rent govern­ment flu­o­ri­da­tion pol­icy is an af­front to med­i­cal ethics and a mon­strous waste of money. North­land MPs and elected DHB mem­bers must take note.

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