The Times: Should we have fluoride in our water?
The Government proposes to let us force water companies to fluoridate supplies. Opponents preparing a human rights challenge say it amounts to poisoning. David Rowan reports
Sue Woodman first knew something was wrong when she noticed a mottled stain darkening her six-year-old daughter Rachel's teeth. Two months later, one of Rachel's new front teeth "sheared off" as she was biting a slice of bread. And then Rachel and her brother Daniel started fracturing their arms and legs after the most minor playground bumps, five or six times each, Sue recalls, prompting the hospital to suggest they might have childhood osteoporosis.
The dentist diagnosed dental fluorosis, a defect in tooth enamel caused by ingesting too much fluoride, which has also been linked to a softening of the bones. He explained that the stains could later be treated. But Daniel became self-conscious about his brown-flecked smile, and as a teenager was almost suicidally depressed. "I thought I'd been a bad mother, even though I'd made sure they brushed their teeth twice a day," Sue says. After all, as a dental nurse, she knew the importance of oral hygiene.
The Woodmans' semi-detached house lies in the Hillmorton suburb of Rugby, an area where Severn Trent Water fluoridates the supply. After thousands of pounds' worth of dental treatment, Daniel, now 28, and Rachel, 26, have gleaming teeth. But their younger sister Hannah, 15, is trying to come to terms with the off-white flecks and shadowy stains that tarnish her teeth. "All my friends have got perfect teeth, and they make fun of me at school, telling me to 'get a toothbrush'."
If Hannah's contemporaries do have gleaming smiles, fluoridation must take some of the credit. But what angers Sue - who believes her family is genetically predisposed to fluorosis - is that no one cautioned of the dangers. "They put fluoride in the water against my will," she says. "By forcing it on to us, they're saying we haven't got the intelligence to make up our own minds."
On Monday, the House of Commons will decide just what rights we have over our drinking water. The Government wants MPs, in a free vote on the Water Bill, to give strategic health authorities the power to force water companies to fluoridate supplies after local consultation. Backed by the British Dental and Medical Associations, the British Fluoridation Society, and various professional health bodies, the vote looks like going the Government's way. If so, an alliance of parliamentary opponents will mount a court challenge on grounds of human rights.
The Government's clumsy lobbying has done nothing to reassure the doubters. It added the pro-fluoridation amendment to the Water Bill at a late stage just before the summer recess, prompting MPs' complaints that they had been "bounced". Then last month Melanie Johnson, the Public Health Minister, wrote to MPs promoting fluoridation as a cheaper, more effective alternative to fluoride toothpaste - forcing her later to clarify that "we are not saying people should stop brushing their teeth".
The British Dental Association (BDA) backs fluoridation on behalf of "hundreds of thousands of children destined to a life of poor dental health and low self-esteem". Because fluoride strengthens tooth enamel, it says, a five-year-old in unfluoridated Bury will have five times the number of missing, decayed or filled teeth than one in fluoridated Burton. The British Medical Association, meanwhile, also supports it and sees no evidence of adverse health risks.
About five million Britons drink water fluoridated at one part per million, mainly in the Midlands, North East and East. Another half million receive water that is naturally fluoridated. The proposed law will legally protect water companies if health authorities tell them to fluoridate their supply and it goes wrong.
Opponents claim this will bring the Government a "huge PR disaster". "They're poisoning children," says Jane Jones who, from her Barnsley kitchen, runs the National Pure Water Association campaign, a leading anti-fluoridation group. "We're talking about industrial grade chemicals, further contaminated by cadmium, arsenic and lead. And dental fluorosis is a sign of poisoning."
Fluoride, say opponents, is linked to thyroid disorders, impaired intelligence, arthritis, premature ageing, musculo-skeletal disease, kidney disease, infertility, central nervous system damage and cancer, and it suppresses human metabolism to make citizens more pliant. Nonsense, responds the BDA; where is the evidence?
Tony Lees, a Herefordshire dentist who opposes fluoridation, questions the BDA's impartiality because it is paid to accredit fluoride toothpastes (the BDA considers the claim contemptible). Then there is the sugar industry's "unseen hand". "Isn't it convenient," Mr Lees asserts, "that fluoridation takes people's eye off the damage sugar is doing?" Professional bodies also question the Government's haste.
Nick Reeves, director of the Chartered Institution of Water and Environmental Management, thinks that the Government's plan "not only contravenes the Human Rights Act, but would appear to violate the Poisons Act, the EU Codified Pharmaceuticals Directive, the Code of Medical Ethics and consumer legislation".
Professor Elizabeth Kay, scientific adviser to the BDA, is exasperated by the "antis". A practising dentist at Manchester's dental hospital (unfluoridated), she spends her days "taking little children's teeth out". It is "nonsense" to see fluoride as a poison; water is certainly not being "medicated". "This law will give local people choice." she says. "At present it is up to the water industry."
Most fluoride in our water is produced industrially during the manufacture of phosphoric acid for fertiliser. Britain's main supplier is Norsk Hydro. Although no longer a producer, the Norway-based multinational meets Britain's needs by importing other companies' fluoride com£through its Lincolnshire plant. The fluoride is supplied in the form of hexafluorosilicic acid, or HFSA (another compound, sodium fluorosilicate, is also permitted). The British Fluoridation Society calls it a "valuable co-product" of fertiliser manufacture; the anti-fluoridation lobby calls it "industrial waste".
Yet the fluoride-supply industry is secretive. "We can't give the name of our suppliers," says Ingegerd Rafn at Norsk Hydro. Nor will she say how much HFSA we import, nor what it earns the company. But in the West Midlands, where 3.7 million people drink fluoridated water, the annual bill (paid by the NHS) is £1.2 million. Still, each unrequired filling saves the NHS £10.
The real problem concerns scientific evidence. In 2000, a team at York University published a review for the Government. It agreed that fluoridation cut tooth decay and found no evidence of health risks, but said more research was needed. The BDA cites the York review as "evidence that fluoridation is effective". The York team is "concerned about the continuing misinterpretations" of its findings, as "we were unable to discover any reliable good-quality evidence in the fluoridation literature worldwide."
The National Pure Water Association's register of objectors now has nearly 400,000 names, with 10 sheets of signatures arriving daily. "People are angry", says Jane Jones. "In a contentious scientific area, shouldn't the precautionary principle apply?" The Government appears to think not. Yet Sue Woodman wonders why, with all the trouble over MMR and GM food, ministers still think they can ignore public concerns over what goes into our bodies.
"It's mass medication, isn't it?" she says. "I just wonder if, 30 years down the line, we're going to find people coming forward with all sorts of fluoride-related problems."
(The Times, November 8 2003)
Sue Woodman first knew something was wrong when she noticed a mottled stain darkening her six-year-old daughter Rachel's teeth. Two months later, one of Rachel's new front teeth "sheared off" as she was biting a slice of bread. And then Rachel and her brother Daniel started fracturing their arms and legs after the most minor playground bumps, five or six times each, Sue recalls, prompting the hospital to suggest they might have childhood osteoporosis.
The dentist diagnosed dental fluorosis, a defect in tooth enamel caused by ingesting too much fluoride, which has also been linked to a softening of the bones. He explained that the stains could later be treated. But Daniel became self-conscious about his brown-flecked smile, and as a teenager was almost suicidally depressed. "I thought I'd been a bad mother, even though I'd made sure they brushed their teeth twice a day," Sue says. After all, as a dental nurse, she knew the importance of oral hygiene.
The Woodmans' semi-detached house lies in the Hillmorton suburb of Rugby, an area where Severn Trent Water fluoridates the supply. After thousands of pounds' worth of dental treatment, Daniel, now 28, and Rachel, 26, have gleaming teeth. But their younger sister Hannah, 15, is trying to come to terms with the off-white flecks and shadowy stains that tarnish her teeth. "All my friends have got perfect teeth, and they make fun of me at school, telling me to 'get a toothbrush'."
If Hannah's contemporaries do have gleaming smiles, fluoridation must take some of the credit. But what angers Sue - who believes her family is genetically predisposed to fluorosis - is that no one cautioned of the dangers. "They put fluoride in the water against my will," she says. "By forcing it on to us, they're saying we haven't got the intelligence to make up our own minds."
On Monday, the House of Commons will decide just what rights we have over our drinking water. The Government wants MPs, in a free vote on the Water Bill, to give strategic health authorities the power to force water companies to fluoridate supplies after local consultation. Backed by the British Dental and Medical Associations, the British Fluoridation Society, and various professional health bodies, the vote looks like going the Government's way. If so, an alliance of parliamentary opponents will mount a court challenge on grounds of human rights.
The Government's clumsy lobbying has done nothing to reassure the doubters. It added the pro-fluoridation amendment to the Water Bill at a late stage just before the summer recess, prompting MPs' complaints that they had been "bounced". Then last month Melanie Johnson, the Public Health Minister, wrote to MPs promoting fluoridation as a cheaper, more effective alternative to fluoride toothpaste - forcing her later to clarify that "we are not saying people should stop brushing their teeth".
The British Dental Association (BDA) backs fluoridation on behalf of "hundreds of thousands of children destined to a life of poor dental health and low self-esteem". Because fluoride strengthens tooth enamel, it says, a five-year-old in unfluoridated Bury will have five times the number of missing, decayed or filled teeth than one in fluoridated Burton. The British Medical Association, meanwhile, also supports it and sees no evidence of adverse health risks.
About five million Britons drink water fluoridated at one part per million, mainly in the Midlands, North East and East. Another half million receive water that is naturally fluoridated. The proposed law will legally protect water companies if health authorities tell them to fluoridate their supply and it goes wrong.
Opponents claim this will bring the Government a "huge PR disaster". "They're poisoning children," says Jane Jones who, from her Barnsley kitchen, runs the National Pure Water Association campaign, a leading anti-fluoridation group. "We're talking about industrial grade chemicals, further contaminated by cadmium, arsenic and lead. And dental fluorosis is a sign of poisoning."
Fluoride, say opponents, is linked to thyroid disorders, impaired intelligence, arthritis, premature ageing, musculo-skeletal disease, kidney disease, infertility, central nervous system damage and cancer, and it suppresses human metabolism to make citizens more pliant. Nonsense, responds the BDA; where is the evidence?
Tony Lees, a Herefordshire dentist who opposes fluoridation, questions the BDA's impartiality because it is paid to accredit fluoride toothpastes (the BDA considers the claim contemptible). Then there is the sugar industry's "unseen hand". "Isn't it convenient," Mr Lees asserts, "that fluoridation takes people's eye off the damage sugar is doing?" Professional bodies also question the Government's haste.
Nick Reeves, director of the Chartered Institution of Water and Environmental Management, thinks that the Government's plan "not only contravenes the Human Rights Act, but would appear to violate the Poisons Act, the EU Codified Pharmaceuticals Directive, the Code of Medical Ethics and consumer legislation".
Professor Elizabeth Kay, scientific adviser to the BDA, is exasperated by the "antis". A practising dentist at Manchester's dental hospital (unfluoridated), she spends her days "taking little children's teeth out". It is "nonsense" to see fluoride as a poison; water is certainly not being "medicated". "This law will give local people choice." she says. "At present it is up to the water industry."
Most fluoride in our water is produced industrially during the manufacture of phosphoric acid for fertiliser. Britain's main supplier is Norsk Hydro. Although no longer a producer, the Norway-based multinational meets Britain's needs by importing other companies' fluoride com£through its Lincolnshire plant. The fluoride is supplied in the form of hexafluorosilicic acid, or HFSA (another compound, sodium fluorosilicate, is also permitted). The British Fluoridation Society calls it a "valuable co-product" of fertiliser manufacture; the anti-fluoridation lobby calls it "industrial waste".
Yet the fluoride-supply industry is secretive. "We can't give the name of our suppliers," says Ingegerd Rafn at Norsk Hydro. Nor will she say how much HFSA we import, nor what it earns the company. But in the West Midlands, where 3.7 million people drink fluoridated water, the annual bill (paid by the NHS) is £1.2 million. Still, each unrequired filling saves the NHS £10.
The real problem concerns scientific evidence. In 2000, a team at York University published a review for the Government. It agreed that fluoridation cut tooth decay and found no evidence of health risks, but said more research was needed. The BDA cites the York review as "evidence that fluoridation is effective". The York team is "concerned about the continuing misinterpretations" of its findings, as "we were unable to discover any reliable good-quality evidence in the fluoridation literature worldwide."
The National Pure Water Association's register of objectors now has nearly 400,000 names, with 10 sheets of signatures arriving daily. "People are angry", says Jane Jones. "In a contentious scientific area, shouldn't the precautionary principle apply?" The Government appears to think not. Yet Sue Woodman wonders why, with all the trouble over MMR and GM food, ministers still think they can ignore public concerns over what goes into our bodies.
"It's mass medication, isn't it?" she says. "I just wonder if, 30 years down the line, we're going to find people coming forward with all sorts of fluoride-related problems."
(The Times, November 8 2003)
posted by David Rowan at Saturday, November 08, 2003
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