18 Jun 2011

Daily Echo "In my view"

'Where is the evidence?'
by Stephen Peckham
IT is to be expected that the British Association for the Study of Community Dentistry (Daily Echo, June 4) supports water fluoridation but surprising that a professional association should claim benefits for water fluoridation that are not supported by good evidence.
While it is true that systematic reviews have shown some benefit, these same reviews highlight that the evidence is both old and of poor quality.
For their president to claim that "the number of children's teeth affected by decay will fall - probably by between about 30 per cent and 50 per cent - and there will also be long-term benefits for adults" is a statement of belief rather than fact.
Our local NHS has had to agree not to state that adults benefit as they could not provide sufficient evidence to the Advertising Standards Agency to back this claim.
Reference is also made in the article to the fact that more than 500 children need a general anaesthetic to have decayed teeth removed. Interestingly many fluoridated areas also have large numbers of children needing teeth removed due to dental decay such as the 600-plus children in fluoridated Wolverhampton.
What we do know, based on experience elsewhere, is that some 40 per cent of children in the city will get dental fluorosis with some of them requiring substantial future dental treatment as they get older.
In areas where fluoridated, some young children and adults consume excess fluoride.
This is the reason major cities in North America have stopped fluoridating their water supplies and, following the lead of Ireland and Canada, the US is now proposing to lower the maximum level of fluoride in water to 0.7ppm.
But apparently it is OK in England to expose us to higher levels of fluoride.
Having attended as a speaker at the British Association for the Study of Community Dentistry's conference in April, I was pleased to find that not all dental public health professionals share their association's views.
In fact one speaker described water fluoridation as "an obsolete and outdated policy that should be abandoned".
We need to listen to wiser words such as those of one of the more eminent members of the association who told me - and the Strategic Health Authority - back in 2008 that there is no evidence to support claims that it will reduce decay levels in the city.

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