LETTERS TO THE EDITOR
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from a value for taxpayer or ratepayer viewpoint it is most concerning that the current coalition government has not withdrawn the iniquitous Health (Fluoridation of Drinking Water) Amendment Bill, which will empower district health boards to direct territorial authorities to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.