Calls for a review of the fluoridation of Palmerston North’s water supply make up the biggest single issue facing the city council in consultation on its draft annual plan.
The council has received 31 submissions calling for a review of the mass-medication practice and four supporting its continuation.
Opponents say the community has never been consulted about fluoridation, that it is no longer the most efficient way to reduce tooth decay, and removing what they describe as a toxic substance could save more than $40,000 a year.
MidCentral Health clinical director of dental services Phil Marshall said removing fluoride from the water supply would expose the most vulnerable members of the community to high levels of tooth decay, pain and infection.
While 60 per cent of the district’s children started school with no fillings, there were children among the remaining 40 per cent who had advanced dental disease, especially in areas with no fluoridation.
It would only be safe to consider removing fluoride if there was a nationally-led, effective oral health programme that ensured all children were brushing their teeth properly twice a day with fluoride toothpaste, he said.
Dr Marshall said current efforts to reach children in lower socio-economic groups and ensure they were practising good oral hygiene were not nearly comprehensive enough.
The worst rates of decayed, missing and filled teeth in the district were in Horowhenua, where the water was not fluoridated, and where there was also a concentration of poorer families and Maori and Pacific Island children.
Between 2006 and 2010, 313 children under 5 years were treated under general anaesthetic at Palmerston North because they had so many rotten teeth school dental therapists could not manage their treatment, alongside another 546 children aged 5 to 14.
There were another 150 on the list now.
“I have not done a full clearance recently but I have done 10 [extractions on one child].
“It’s pretty disheartening.”
Dr Marshall said it was true that fluoridation alone did not prevent tooth decay but it did bring rates down by 30 to 40 per cent in vulnerable groups.
“Don’t take fluoridation away until we have an effective alternative, or it will expose the most vulnerable,” he said.
“The most recent reviews continue to provide confidence that community water fluoridation programmes are both safe and effective.”
In 1958, Paul Rieger, later to become Palmerston North mayor, led a Jaycees co-ordinated deputation, supported by doctors and dentists, that convinced the city council of the benefits of fluoridation. He said he had no doubt it was the right decision at the time and he continued to support it.
“But I would not oppose a review.
“The evidence would still justify it.” He said that for some groups, fluoridation was still the best way to reduce the impact of decay.
“If you could get the same result with better oral health and brushing, that would be great,” he said.
But meantime, no “orthodox” science would support the idea that the level of fluoride in the city’s water was doing anyone any harm, he said.
Mr Rieger said fluoridation was a safety measure as valid as speed limits on the roads.