This week, leaked Government papers revealed plans to add fluoride to all drinking water in England and Wales.

Although the addition of fluoride to our water has been proved to reduce tooth decay, it is controversial – fluoride may also be linked to increased risks of osteoporosis, kidney problems, and even cancer, and some say it is stealthy mass medication.

So what exactly is fluoride, why is it being added to our water, and are we right to be concerned?

Fluoride is a mineral occurring naturally in soil, water, plants, and animals in trace quantities. It is also an entirely natural component of bone. In water, fluoride is in the form of calcium fluoride (CaF2). But artificial fluoride (used in the water fluoridation process) is also found in pesticides.

WHERE IS IT FOUND?

It occurs naturally in tea leaves and vegetables such as endives and curly kale. Artificial fluoride is found in toothpastes, tooth gels and mouth rinses – in Europe, it is even added to salt. Half the fluoride ingested is retained in the body – in the bones and teeth – the other half is excreted.

WHY IS IT GOOD FOR YOUR TEETH?

When teeth are being formed, fluoride safely strengthens the enamel, the hard outer ‘shell’ of the tooth. This, in turn, stops cavities from forming and teeth from decaying. The fluoride content of tooth tissues reflects the available fluoride at the time of tooth formation. This is why it’s important to have sufficient fluoride when teeth are forming.

HOW MUCH FLUORIDE IS TOO MUCH?

About 2mg daily is considered safe and adequate (six cups of tea will contain around 1mg of fluoride). However, taken in quantity it is extremely toxic and dangerous. Just over 2 grams of fluoride (roughly a teaspoon) is enough to kill an 11st adult, while just 300mg (found in a tube of toothpaste) is enough to kill a 1st 6lb child. The lethal dose of artificial fluoride is 50 times smaller than natural fluoride.

WHAT ARE THE ADVANTAGES OF FLUORIDE IN OUR WATER?

A letter from the Health Minister, Hazel Blears and Environment Minister Elliot Morley said: ‘Experience of oral health promotion projects shows that it is much harder to establish regular tooth-brushing in deprived areas because of the costs of toothpaste and, perhaps, because of the less ordered lifestyles of the families.’

Statistically, by the age of five, nearly two-thirds of children in some parts of the UK have at least one rotten tooth. Research by the NHS Centre for Reviews and Dissemination (CRD) found that children living in fluoridated areas suffered an average of 15 per cent less tooth decay compared to those living in nonfluoridated areas.

They also had a lower average of decayed, missing and filled teeth, and a greater proportion were completely free of decay.

HOW IS WATER FLUORIDATED?

Water companies add disodium hexafluorosilicate and hexafluorosilicic acid to water. The legal limit, where water is treated, is one part per million (1 ppm equals 1 mg per litre).

WHICH AREAS OF ENGLAND ALREADY HAVE FLUORIDATED WATER?

ABOUT 11 per cent of the population (5 million) already receive fluoridated water – in Birmingham, the West Midlands and on Tyneside. Another 500,000 from Hartlepool to parts of Essex have naturally fluoridated water.

Research revealed children’s teeth were three times healthier in and around Birmingham, where tap water has been fluoridated for nearly 40 years, than in Manchester, where it is not.

In Scotland mass fluoridation has been proposed but is meeting strong opposition during a consultation phase on ethical grounds.

WHERE ELSE IS WATER FLUORIDATED?

More than 150 million people in the U.S. drink fluoridated water – although 50 cities or towns have withdrawn fluoride from supplies since 1990. Their legal limit, of four parts per million – is four times our legal limit.

WHERE HAS IT BEEN BANNED?

Fewer than 2 per cent of Europe’s population have fluoridated water. Last year the Belgian government outlawed the sale of fluoride tablets and chewing gum.

This was based on fears that it might increase the risk of osteoporosis. France, Italy, Germany, Sweden, Denmark and Holland have also rejected mass water fluoridation. There has also been mounting opposition to it in Ireland.

WHAT ARE THE SAFETY WORRIES?

A large review of the scientific literature on water fluoridation was recently published in the British Medical Journal. This showed that just one in six people drinking fluoridated water appears to benefit.

FLUORIDATION HAS BEEN LINKED TO:

Dental Fluorosis: Almost half of people drinking fluoridated water at permissible levels, one part per million, exhibit dental fluorosis. White and brown spots appear on the enamel of the teeth – causing an unsightly ‘mottled’ effect.

This is the first sign that fluoride has poisoned enzymes in the body. Some dentists understandably question the wisdom of preventing dental disease in one in six people, only to cause it in one in two.

Skeletal Fluorosis: According to American research, this crippling disease – symptoms include pains in the bones and joints, muscle weakness and gastrointestinal disorders – may occur in people who have ingested 10-20mg of fluoride per day for 10 to 20 years (equivalent to 2.5-5 mg per day for 40-80 years). In the most severe cases, the spine becomes completely rigid.

Osteoporosis: Although fluoride exposure results in denser bones, the bone appears to be weaker than normal bone. Scientists in America have reported that fluoride in strengths as little as 1 part per million decreases bone strength and elasticity.

Additionally, in 1992, a study of elderly patients in Utah found ‘a small but significant increase’ in the risk of hip fracture in both men and women.

Cancer: In 1992, a study by the New Jersey Department of Health in the U.S. found a strong link between fluoridation and bone cancer ( osteosarcoma) in young males. They reported that osteosarcoma rates were three to seven times higher in fluoridated areas than non-fluoridated areas.

This disease is routinely found to be more common in males than in females and it has been reported that at very low levels fluoride can interfere with the male hormone testosterone.

Kidney Problems: A study published in the journal Urological Research has found an association between high levels of fluoride in the water and painful kidney stones. According to the study, urolithiasis (kidney stones) was 4.6 times more common in an area with high fluoride (3.5 to 4.9 ppm) than in a similar area without high fluoride. Moreover, in the high fluoride area, the prevalence of kidney stones ‘was almost double in subjects with fluorosis than without fluorosis’.

WHAT NEXT?

Ministers will introduce the change in amendments later this month to the Water Bill, allowing the 28 strategic health authorities in England to order the fluoridation of water after local consultation.

A document signed by health and environment ministers last month concludes that opponents are in the minority and that ‘this minority should not be allowed to deprive health communities from opting for fluoridation by insisting on an indefinite research programme’.

It seems the only way to avoid the fluoridated water is either to buy water filters or spend a small fortune on bottled drinking waters – as many of us already do.