February 26, 2009

experts respond to the announcement on the fluoridation of water from South Central Strategic Health Authority

The City of Southampton will be the first in the UK to go ahead with a scheme to add fluoride to tap water on a large scale.

Peter G Robinson, Professor of Dental Public Health, University of Sheffield, said:

“The very best evidence indicates that adding tiny amounts of fluoride to drinking water reduces the amount of tooth decay in children by about a third.”

Hugh Whittall, Director of the Nuffield Council on Bioethics, said:

“Whether water fluoridation is right or wrong should always be a local decision, weighing up the possible costs and benefits for people that live in that area, and the Health Authority should be applauded for tackling this question head-on in an open and transparent way.

“This is a very controversial issue and either way the decision was going to be unpopular with some people. Deciding not to fluoridate a water supply is as much a policy decision as deciding to fluoridate, as both will have consequences for the local population. The important thing is that the evidence and the options have been properly examined, and everyone has had a chance to contribute to the debate.”

Nick Reeves, Executive Director of CIWEM, said:

“Fluoridation is a complex issue, bringing concerns about how the Government uses its power to impose mass medication on the public. There are also concerns about the need for careful monitoring of fluoride levels. This is not a cheap option and could open up the floodgates for ongoing litigation.

“CIWEM calls for more research to be undertaken on fluoridation programmes focusing on sound science, ethical issues and legalities. Manufacturing, transporting and disposing of chemicals may have a detrimental effect on the environment so also require further investigation.

“CIWEM believes that the issue of monitoring natural fluoride levels needs to be addressed. Much water contains natural fluoride at varying levels. Fluoridation therefore requires the level of naturally occurring fluoride to be monitored closely and dose rates adjusted accordingly. This will be costly and may introduce risks associated with the accuracy of measurements and dosing controls, as well as the reaction and compatibility of natural fluoride compounds with dosed ones. CIWEM believes that the full cost of fluoridation, including any liabilities, should be borne by the Health Protection Agency.

“All benefits of fluoridation programmes must be considered in the context of wider public health provision and that people should have the freedom to choose how they meet their dental care needs. People must be provided with information that will enable informed decisions and the Government and the health agencies play a key role in its provision.”