RECENTLY some claims regarding water fluoridation have been made in the Mildura media.
While it is important to discuss this program, it is also important that information presented to the community is factual and can be supported by credible scientific and medical evidence.
The addition of fluoride to drinking water is one of the great public health achievements of the 20th Century.
At optimal levels (1mg/L, also known as 1 part per million), fluoride significantly reduces dental decay and is confirmed as safe and effective by Australia’s National Health and Medical Research Council (NHMRC), the World Health Organisation and numerous other medical, scientific and research organisations.
The NHMRC is Australia’s peak health body for the achievement of the best possible standards for individual and public health.
In 2007, it commissioned a review to evaluate scientific data on fluoridation.
The review affirms that water fluoridation remains the most effective and socially equitable means of achieving community wide exposure to the caries prevention effects of fluoride.
With regard to kidney disease, Kidney Health Australia (KHA) recommends water as the fluid to satisfy thirst and states that no evidence exists that consumption of optimally fluoridated drinking water poses any documented health risk for people with chronic kidney disease, although only limited relevant studies are available.
Further, KHA has not called for the cessation of water fluoridation programs (http://www.kidney.org.au/HealthProfessionals/PositionStatements/tabid/725/Default.aspx).
In the case of dialysis it is important to note that this treatment has been successfully conducted in fluoridated towns and cities in Australia for decades.
All dialysis units have sophisticated filtration systems which deionise the water to remove all electrically charged particles, not just fluoride.
This ensures the unit is able to filter the patient’s blood appropriately.
In relation to diabetes, Diabetes Australia is unaware of any evidence worldwide of a biological link between fluoridated waer and insulin regulation.
Diabetes Australia recognised the increased risk of dental probelms for people with diabetes and the importance of oral health and dental care as an integral part of diabetes management.
Diabetes Australia supports Healthy Mouths Healthy Lives: Australia’s National Oral Health Plan 2004-2013, which includes the goal of extending water fluoridation to communities across Australia, such as Mildura.
In relation to asthma, the Asthma Foundation of Victoria says there is very little evidence based research or data available from well controlled studies to support any claim that fluoride is a respiratory allergen that could exacerbate symptoms of asthma or cause a severe asthma attack.
Along with other leading health authorities, including the American Academy of Allergy and Immunology, the Asthma Foundation of Victoria does not oppose water fluoridation.
In relation to cancer, there is no established link between water fluoridation and any cancer, including bone cancer.
The Cancer Council Victoria endorses the water fluoridation program in Victoria.
Some concern has been raised about American Dental Association advice on infant formula.
This advice was based on the naturally high levels of fluoride in some US water supplies.
This is not the case in Australia where it is safe to reconstitute infant formula with fluoridated water.
We are aware of studies conducted in China regarding water fluoridation and IQ but these have little practical relevance to Australia.
We note that these studies involved children’s exposure in “high fluoride areas” where fluoride levels are substantially higher than the levels used in Australia.
These studies do not show negative effects at Australian fluoride levels.
On the question of the need for dental professionals once the fluoridation program comences, it is important to recognise that although water fluoridation helps protect teeth against decay, no single measure can fully proect against dental decay.
So even if the water if fluoridated people still need to look after teeth through regular brushing, appropriate use of fluoridated toothpaste, healthy diet and regular dental check-ups.
In response to claims that the Department of Human Services has not engaged the local community on the water fluoridation issue, it is important to note that all residents in the Mildura area who will receive fluoridated water were sent information booklets in early September 2008.
Furthermore, two communitiy information sessions were conducted in mid-September 2008.
Briefings were also provided to Mildura City Council, the local health sector and Lower Murray Water.
All residents who will receive fluoridated water will be informed again just before the commencement of water fluoridation in the near future.
Governments and health professionals have a responsibility to make decisions that balance the best possible community health outcomes with individual choices.
In 2004, all Australian Health Ministers endorsed water fluoridation as a national oral health initiative – a key action in Healthy Mouths Healthy Lives: Australia’s National Oral Health Plan 2004-2013.
We look forward to the people in MIldura receiving the signifiant public health benefits of water fluoridation in the near future.
Dr John Carnie
chief health officer
Dr Timothy Mathew
Kidney Health Australia national medical director
Dr Ralph Audehm
Diabetes Australia, Victoria director programs and services
Asthma Foundation of Victoria chief executive
Prof David Hill
Cancer Council Victoria director
Mildura Base Hospital chief executive
Mildura Private Hospital general manager
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Letter was partially reprinted on September 2, 2009, and is available athttp://mildura.yourguide.com.au/news/local/news/news-features/experts-back-fluoride/1611648.aspx