Sir, – Ireland has a considerable history of water fluoridation. It is 50 years since fluoridation of the water supplies began in this country. Time for the considerable advantages in terms of improvements in oral health to be demonstrated and, in parallel, time during which there has been no documented medical side-effects of water fluoridation.

In the time since water fluoridation was introduced here in Ireland, the population has benefited from improved oral health services, greater access to fluoridated toothpastes and better nutrition.

As a consequence, a decision was made, after scientific review, to reduce the level of fluorides in the water supply as in other countries.

This is in recognition of these other sources of fluoride and to minimise the side-effect (flecking of teeth) seen when small children eat fluoridated toothpaste while living in fluoride areas.

The benefits of fluoridation are not inconsiderable in terms of all costs. While the population, both adults and children, have benefited from the consequent improvements in oral health that fluoride confers, the benefit to the health service in terms of a reduction in costs of the burden of dental disease and its management, not to say the considerable benefits to families in quality of life as a result of days free of dental pain and no loss of days at work or school in dealing with dental abscesses, are considerable.

Dental disease is one of the commonest, preventable diseases yet the country invests significant amounts of money in dealing with the consequences of that disease. Fluoridation has been proven to have significantly benefited the population thus allowing scarce health service resources to be directed towards acute life-threatening conditions.

No other health-promoting measure has been exposed to such scrutiny and been given an ongoing, clean bill of health. As a measure, water fluoridation has been recognised by the US Cancer Society, as well as the Royal College of Physicians, both here in Ireland and the UK, as being both safe and effective as well as without side effects over decades of vigilance.

We note that the most recently published expert peer-reviewed analysis by the Royal Society of New Zealand finds “there are no adverse effects of any significance arising from fluoridation at the levels used in New Zealand” (ie levels higher than in Ireland). “In particular, no effects on brain development, cancer risk or metabolic risk have been substantiated”. The American Dental Association “unreservedly endorses the fluoridation of community water supplies as safe, effective and necessary in preventing tooth decay.”

As parents as well as oral healthcare professionals, we acknowledge these endorsements and continue to advocate one of the few truly cost-effective public health measures this country has known, for the good of all, children and adults. – Yours, etc,

Prof JUNE NUNN,
Dean, School of Dental Science,
Trinity College Dublin;

Prof MARTIN KINIRONS,
Dean, School of Dental Science,
Cork University Dental School and Hospital;

Dr JOHN WALSH,
Dean, Faculty of Dentistry,
Royal College of Surgeons in Ireland;

Dr PETER GANNON,
President, Irish Dental Association.