Water fluoridation

Fluoridation of water…

The campaign against the mandatory fluoridation of public water supplies in Ireland has been growing for many years, indeed ever since the first objection was raised back in the 1963. However, the debate on the subject will soon reach a critical point with the Fluoridation Forum due to report to the Health Minister shortly. The National Forum was convened in May 2000.

In recent years the clamour against the mandatory fluoridation of water has become organised and significantly more vocal. Lobby groups like Fluoride Free Water have kept the issue in the public eye. In addition to ten local authorities, including Dublin, Kerry, Sligo, Donegal, Leitrim and Longford and seven urban district councils, the Consumers Association of Ireland (CAI) is the latest of a number of independent organisations that have voted against fluoridation of water supplies.

"We are of the opinion that Government policy should now change to allow every consumer choice in the matter of fluoridation of drinking water supplies", explained Michael Kilcoyne, the CAI's chairman. "It's a question of choice. If you buy a glass of beer, the chances are it contains fluoride. The consumer should have the choice on whether or not to have water that contains fluoride".

Anti-fluoride campaigners take to the streets of Dublin.

These groups have been joined by a small number of dentists and doctors, whose opinions on the issue contrast sharply with most of their peers. The big question is - is adding fluoride to almost 75% of the state's water supply protecting our teeth or actually damaging them?

Mandatory

The concerns over the addition of fluoride to drinking water are related to both the mandatory nature of the practice and to the additive substance itself. Hydrofluorosilic acid, the means by which fluoride is added to water, is an industrial by-product. Its means of production need not necessarily be of concern if the substance has proven health benefits for all, but opponents to mandatory fluoridation allege that excess fluoride can be linked to a range of diseases, including osteoporosis and thyroid cancer. However, properly conducted studies have yet to categorically link the addition of fluoride to drinking water with any condition other than dental mottling - the fluorosis effect.

Fluoridation first became popular in America when it was discovered that areas where the water was rich in naturally occurring fluoride experienced less dental caries. It was already known that excessive fluoride could cause teeth to mottle, meaning that the enamel surface would become uneven. Fluoridation remains popular in the United States, but in Europe many countries have withdrawn from the practice. In fact, Ireland remains the last full territory in Europe to add fluoride to drinking water.

Studies

Confusion and concern among the public has risen to fever pitch in recent months as conflicting reports about the efficacy or danger of fluoride have emanated from both the pro and anti camps. Recently, a highly publicised study from the Dublin Dental Hospital that apparently indicated that infants were receiving poisonous levels of fluoride turned out to be an undergraduate research project.

The lobby group fluoride Free Ireland has raised the issue of medical licensing for the fluoride added to Irish water. If fluoride offers health benefits, it should be licensed by the Irish Medicines Board, they argue. The IMB's enforcement officer Mr Hugo Bonner responded to this issue in a speech delivered at Trinity College Dublin recently.

"There are many substances available in the country of which the Irish Medicines Board is aware of but have not decided to take action on", he said. He added that if the substance in question, hydrofluorosilic acid, was unsafe, it would have been banned by the Environmental Protection Agency.

However, Dr Paddy Flanagan of the EPA is on record as saying that the agency's role does not encompass 'any competence or function in topics which affect public health'. Instead, the EPA is charged simply with analysing the constitution of drinking water and reporting on the results. While this includes monitoring fluoride levels in Irish drinking water, it does not include decision-making in the public health debate over the addition of fluoride.

Fluoride is added to substances other than water, including toothpaste.

So who is responsible for deciding if the addition of fluoride to our drinking water is a good, or even a safe thing? Ultimately such policy decisions are usually made by the Department of Health, which set up the National Forum to look into the entire issue. The Forum threw the floor open to the public in order to gain as many opinions as possible and received over 1,000 submissions.

Abusive calls

Such has been the passionate nature of the debate, some individuals have made irate and even abusive telephone calls to the secretariat of the Fluoridation Forum. Two of the members of the Forum also said that they had received calls of a similar nature. With tensions running so high, will everyone appreciate a measured and considered appraisal of fluoridation from the Forum? And if a decision is taken to continue with fluoridation, what will be the response from the lobby groups, dissident dentists and others who are strongly against the measure?

It may be that the Forum may not get the chance to deliver its verdict, as a well-known GP from Kildare has recently taken the issue out of the press, off the streets and into the courts. Dr Andrew Rynne has issued proceedings against the Department of Health and the Irish Medicines Board, claiming that the mass fluoridation of the populace is unconstitutional. Dr Rynne argues that fluoridation contravenes the Convention of Human Rights on biomedicine signed in Strasbourg in December 1999. If his High court case is successful, it could leave the Forum's report in limbo.

"It is a philosophical matter", Dr Rynne said. "People are being medicated by the State without their approval. Being medicated means being given any substance with a view to diagnosis, treating or preventing a disease. No studies have been done in 40 years to ascertain the levels of fluoride in the Irish population. Everybody in Ireland is taking in unknown quantities and qualities of fluoride every day, depending on their level of consumption".

The Department of Health may have hoped that in setting up the Forum, the controversy over fluoridation might abate, at least until its report had been heard. But by all accounts, the real battle may be only about to begin.


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