UK Councils Against Fluorida-tion (UKCAF; www.ukcaf.org), which represents 74 local councils opposed to fluoridation, has sent out a letter of warning to every council, pointing out the legal implications of their new powers.
If they decide to fluoridate the water supply, councils leave themselves open to claims for damages from parents if their children develop dental fluorosis, a common disfiguring condition caused by fluoride that damages the enamel on teeth. The council could also face criminal charges for promoting an unlicensed medicinal product, as UKCAF believes fluoride in public water is.
These new powers are included in the wide-ranging Health and Social Care Bill, which seeks to change the power base of the National Health Service (NHS). The bill, which is passing through Parliament, also transfers responsibility for fluoridation from strategic health authorities to local councils. Local councils within a water-board area will need to consult and arrive at a consensus view before fluoride can be added to the public water, the bill states.
UKCAF's director Liz Vaughan fears that the decision-making process is merely window dressing, and that local authorities will have no other option than to fall in line with the current government thinking, which seems to be roundly in favour of further fluoridation.
The Department of Health, in a document that accompanies the bill, states that "fluoridation can significantly reduce inequalities in oral health between affluent and less affluent areas", but accepts that the subject remains contro-versial. Once the bill becomes law, the health secretary will have the power "to specify particular public health services that local author-ities must provide to ensure their national availability". Ukcaf fears that water fluoridation will be among the compulsory public-health services that local councils will be forced to implement, possibly even without public consultation.
Even though local councils might be merely the implementers of national government bidding, they-and even individual councillors who vote for water fluoridation-will be in the direct firing line when lawsuits are issued.
The medicine that isn't
The first will be claims for damages from parents whose children are suffering from dental fluorosis as a direct result of fluoridation. The condition, in which the enamel of the teeth becomes discoloured, affects up to half of children in fluoridated areas, while around one in eight has a more severe reaction wherein the teeth become badly discoloured and deformed. In these cases, dental remedial work is needed, and costs for aesthetic treatment-which may not be covered under the NHS-can run into thousands of pounds, says Ukcaf. In addition to costs, parents may also win damages to compensate for any mental harm their child may suffer.
The second charge-criminal prosecution for promoting an unlicensed medical product-highlights the confused thinking in government about fluoridation. In 1983, Lord Jauncey ruled in a Court of Session in Edinburgh that fluoride "in whatever form it is ultimately purchased" is a medicinal product as defined by the Medicines Act 1968. As Lord Jauncey pointed out, fluoride is supposed to have a beneficial medical effect-it is promoted as a preventative of dental caries (tooth decay)-and is therefore a medicine. Under the Medicines Act, no medicinal product can be supplied unless it has marketing authorization from the Medicines and Healthcare Products Regulatory Agency (MHRA)-and fluoride has never been granted that authorization.
This is because the MHRA-a government body-has refused to accept that water fluoridation is a medicine. This ambivalence is compounded by the government and its health advisors who, of course, believe it has medicinal benefit.
They maintain that fluoridated water helps to prevent tooth decay in poorer communities, where diet and lifestyle may lead to more dental caries-even though it increases the risk of fluorosis in
Diluting the problems
Successive UK governments-whether Conservative or Labour-have made moves to get the nation's public water fluoridated. Four years ago, the government of the time was accused of massaging research findings in order to make the issue of fluoridation more palatable to the public. Professor Trevor Sheldon, pro-vice-chancellor of York University, who prepared a government-commissioned report, accused ministers of "one-sided handling of the evidence". The Department of Health used the evidence "selectively . . . to give an over-optimistic assessment of the evidence in favour of fluoridation", he said (BMJ, 2007; 335: 699-702).
The UK government's enthus-iasm for fluoridation is also out of step with other members of the EU. Only the Irish Republic has comprehensively introduced fluor-ide into its tap water-more than 70 per cent of public water there is fluoridated-and yet, it has one of the highest rates of tooth
decay in all of Europe. One study discovered that three out of four children in Ireland have tooth decay by the time they reach the age of 15, and 40 per cent have fluorosis (www.irishhealth.com).
The Irish phenomenon is not an anomaly. Health authorities in New Zealand during the 1980s were seeing similar results. The country's then chief dental health officer said at the time: "When any unfluoridated area is compared with a fluoridated area of similar income level, the percentage of children who are free of dental decay is consistently higher in the unfluoridated area".
His observations have been confirmed in studies from the US and Canada; one discovered no difference in levels of tooth decay in fluoridated and unfluoridated areas (Fluoride, 1990; 23: 55-67), while others have demonstrated that decay is less common in unfluoridated regions (J Can Dent Assoc, 1987; 53: 753-5).
Not only is fluoride ineffective, it is also hazardous to health, and it has been associated with diseases far more serious than just fluorosis.
Fluoride is a poison that is more toxic than lead. We are exposed to two forms of it every day: sodium fluoride is added to toothpaste, mouth rinses and gels, while hydrofluorosilicic acid is used in the public water. Even its pro-ponents accept that fluoride can be lethal at high quantities, but they argue that our exposure is minimal.
However, in assessing the levels of fluoride we absorb, scientists are not including all the sources to which we are daily exposed. In addition to brushing our teeth in it, it is also in pesticide-laden food, in the air we breathe, the tea we drink and the pharmaceuticals
we take-and is even found in preparations for babies.
Even so, say advocates, fluoride has a very short half-life of just
210 minutes-which means that the body is clear of it within that time-but evidence suggests that it accumulates in the blood, bones and soft tissues over a lengthy period, and can even reach toxic levels as a person ages. As a result, it has been suspected to be a cause of osteoporosis and hip fracture (JAMA, 1992; 268: 746-8), and can reach levels of low toxicity that nonetheless cause bone damage within 38 years.
Fluoride toxicity has also been linked to thyroid disease, manifesting as general fatigue, to heart irregularities and to low blood pressure (Publ Health Report, 1956; 71: 459-67), and to neurological problems such as vertigo, visual disturbances and mental acuity (Fluoride, 1975; 8: 61-85).
An ME connection
A large body of evidence is also linking fluoride to ME (myalgic encephalomyelitis). Researchers have seen similarities between the symptoms of ME and early-stage fluoride poisoning (Fluoride, 1998; 31: 13-20), possibly because it inter-feres with the movement of white blood cells, reducing the body's natural infection-fighting capa-bility (InterAction, 1994; 14: 53-4).
Not surprisingly, the European Commission's Scientific Com-mittee on Health and Environ-mental Risks (SCHER) has been reticent to recommend wide-spread water fluoridation. In its preliminary note, the committee states: "Fluoridation is a crude and rather ineffective form of systemic fluoride treatment to prevent dental caries without a detectable threshold for dental and bone damage."
Despite the evidence and hesitancy within the EU, the UK government seems set to follow the British Dental Association's agenda and push for mass water fluoridation throughout the country. And with the local authorities in the direct firing line, and likely to be seen as the 'bad guys' if public opinion is strongly opposed to fluoridation, why should they worry?
Factfile: Symptoms of fluoride poisoning
After studying 112 people with fluorosis, researchers have drawn up a list of symptoms of early-stage fluorosis poisoning (Fluoride, 1998; 31: 13-20) that usually manifest before bone damage.
- Musculoskeletal Arthritis (cervical and lumbar spine), muscle pain, pins and needles, inability to control extremities
- Gastrointestinal Gastric pain, nausea, vomiting, bloating, diarrhoea, constipation, acute abdominal episodes, mouth inflammation
- Neurological Migraine-type headache, blurred vision with moving spots (floaters), convulsions, muscle fibrillation (contractions, twitching)
- Respiratory Nasal problems, emphysema, asthma, nosebleeds
- Skin Dermatitis, inflammation around capillary blood vessels
- General Cough, excess mucus, breathing difficulties, mouth ulcers, bleeding gums, palpitations, vertigo, sleep problems, excessive thirst, excessive urination, joint pain, rash, memory loss, tinnitus (persistent ringing in the ears), fatigue.
WDDTY 22 no 7, October 2011