Shortly before the 2001 Value For Money report identified the health service’s critical weakness in policy assessment, one of Ireland’s most sacred health policies, water fluoridation, came under its first intense public questioning. The health minister did not engage with the questioners directly, but initiated instead an official departmental response that did not adequately scrutinise or assess the policy issues. While there have been several high-profile health scandals, the seven-year long cover-up of water fluoridation surely ranks as one of the least defensible.
From the outset, Irish confidence in water fluoridation has been absolute, as articulated in 1964 by the Supreme Court judge, Cearbhall Ó Dálaigh:
“To deal with the [caries] problem the Oireachtas has chosen a method, namely, the fluoridation of the public water supply. The plaintiff [Gladys Ryan] has failed to refute the evidence that this is not only the most effective method but is indeed the only effective method.”
Absurd as this opinion was then, it is one that is still used by dental advisers with the Health Minister today. It is also employed by the Irish Expert Body on Fluorides and Health and the Fluoridation Forum, whose 296-page report has been criticised as “defective” by a former chairman of the Western Health Board, Senator Terry Leydon.
Let’s look at some of the main defects of this opinion. Firstly, the size of the current caries problem bears no comparison with the problem of 40 years ago. In contemporary society Ireland has a similar incidence of tooth decay as the rest of Europe, with between one and two decayed teeth per child.
Secondly, the caries problem has been overcome in the rest of Europe by a variety of means other than water fluoridation, indicating other methods (such as education on proper toothbrushing and diet) have been equally effective.
Thirdly, the idea that swallowing fluoride in water is the only effective method of dealing with dental caries is now so absurd that it would be laughable were it not for the fact that the Expert Body spent three hours arguing just that at the Joint Oireachtas Committee on Health on February 8, 2007.
Leaving aside the question of effectiveness, there are other equally compelling objections to fluoridation, namely the toxicological effects, which the Expert Body admitted to the Committee that it is not an expert on. Incredibly, the Expert Body has been unable to acquire the services of a toxicologist since its inception in April 2003. Bearing in mind that the toxicological effects were instrumental in rejecting the policy in most European countries – in the case of Sweden as long ago as 1972 – the Expert Body’s claim on March 13, 2007 that “there is no health risk to any member of society including babies from consumption of fluoride… at the levels of fluoride observed in Ireland” is both indefensible and irresponsible.
Fortunately, however, the reality of the risk to bottle-fed infants from fluoridated tap water was fully exposed by the Health Committee who again criticised the Food Safety Authority of Ireland for retracting advice to parents in 2001 not to use fluoridated water in infant formula. With the American Dental Association having confirmed the same advice as recently as November 2006, the Health Committee now has a clear and urgent duty to call for water fluoridation to be stopped.