Three years ago, when the country’s local authorities were required to fluoridate drinking water, the Health Ministry determined, based on solid scientific evidence, that it had no health risk and would prevent tooth decay. However, a panel of water experts appointed by the ministry two years ago now says that the fluoridation of water must continue, but should be reviewed in another five years, after a survey on its impact, which will begin in Jerusalem this year, is completed.
The committee, headed by Prof. Avner Adin of the Hebrew University’s Agriculture Faculty in Rehovot, was established to probe the need for revising regulations over the quality of drinking water. Last week, the panel presented its interim report to the Knesset’s Interior and Environment Committee, and its final report will be submitted to the Health Ministry next year.
The committee made several statements about fluoride based on knowledge and experience accumulated worldwide. Its report notes that in countries where fluoride is used, there is a 15-percent increase in the number of children with no cavities, compared to areas where there is no water fluoridation. However, when it comes to tooth decay, it appears that the improvement in countries with water fluoridation is similar to that in countries where water is not fluoridated. “Apparently this stems from the fact that many countries have better hygiene habits, including using toothpaste,” Adin says.
The committee was presented with arguments made by fluoridation opponents, who say that the planned program involves the use of a substance whose health and environmental impacts have yet to be fully investigated. The committee determined that it seems that the health benefits of fluoridation outweigh its disadvantages, but noted that studies attempting to determine whether fluoridation is beneficial or harmful involved only medium- or low-level research.
“Israel and Ireland today are the only countries in the world requiring the addition of fluoride to drinking water,” Adin says. “The only negative impact of using this substance for which there is agreement is an increase in the number of cases of fluorosis, which is an aesthetic problem whereby the teeth lose their luster or appear stained. But this, too, is a problem that should be addressed.” Adin says the committee feels it would be worthwhile to take advantage of the fact that a water fluoridation program in Jerusalem begining this year will allow officials to conduct a study of various health aspects before and after the fluoridation. Among other things, the study, which will be conducted by an independent steering committee, will examine the extent of fluorosis among individuals.
Led by the Israel Union for Environmental Defense (IUED), the public’s fight against fluoridation is continuing in several communities. In Nes Tziona, for example, two local residents, Ze’ev Shafir and Dr. Mordechai Hochberg, a nutrition expert, are trying to drum up public backing.
Hochberg says he became involved in the issue after reviewing studies on the subject published worldwide and found it entailed health risks such as damage to the bones and nervous system.
MK Gila Finkelstein (National Religious Party) submitted a bill banning the fluoridation of drinking water. In last month’s discussion about the proposed bill, Health Minister Dan Naveh said that according to professionals in his ministry, fluoridation was enacted in Israel after numerous studies were conducted here and abroad. These studies proved that fluoridation was very effective in preventing tooth decay, and determined that there was no proof of damage to health.
“Studies done abroad found little effectiveness in preventing tooth decay,” says the IUED’s Shimon Tzuk, a hydrologist who is a member of Adin’s committee representing public organizations. “There is no justification for spreading thousands of tons of an acidic substance in Israel when its benefits are in doubt, and it is known that the substance leaches into water sources and the ground and pollutes them at a later stage. Fluoridation is unnecessary, and Jerusalem residents don’t have to serve as lab mice to test this.”
Aside from fluoridation, the committee made a series of recommendations on water treatment, including revising regulations so that drinkable water should contain no coliform bacteria and fecal coli bacteria. Current regulations allow for a concentration of three bacteria of each type per 100 milliliters of water. “This is a step that would require the addition of more water filtering and disinfecting facilities, and is in line with similar regulations elsewhere in the world,” Adin says.