EXPERTS went head-to-head as some 120 people packed into the Promenade Methodist Church, on Loch Promenade, Douglas, to hear the arguments for and against fluoridation.

The case for each side was presented respectively by Professor Michael Lennon, chairman of the British Fluoridation Society, and Dr Paul Connett, professor emeritus of chemistry at St Lawrence University and executive director the Fluoride Action Network.

Organised by the Isle of Man Campaign for Non-Fluoridated Tap Water, the meeting sparked lively debate.

THE CASE FOR FLUORIDATION

INTRODUCING Prof Lennon, public health director Dr Parameswaran Kishore, said: ‘To me the real issue is not whether we fluoridate water or not but how we prevent dental caries.

‘Rates of dental decay are equivalent to some of the worst areas in the UK. We also know children from deprived backgrounds have disproportionately more caries and the third factor is that natural levels of fluoride in the Isle of Man are low. Dental caries cause a lot of misery.’

Conceding that fluoride can cause fluorosis, he asked: ‘Would you prefer to have slightly mottled teeth or no teeth at all?’

And he urged the audience to treat with caution statistics presented as independent medical evidence that may not actually show the true or full picture.

Taking the stand, Prof Lennon explained the concept was not a new idea, the beneficial effects of naturally-occuring fluoride first recognised in the 1920s and the city of Grand Rapids in the US being the first in the world to have it artificially added to the water supply back in the mid 1940s.

Some 350 million people worldwide and 5.5 million in the UK now drink fluoridated water, with fluoride introduced at the optimum level for dental health at one part per million.

‘My daughter and her young child live in New York and they are drinking fluoridated water and I’m delighted that they are,’ he said.

Prof Lennon said he was ‘astonished’ at the number of children requiring tooth extraction under general anaesthetic at Noble’s Hospital – ‘a really traumatic experience’ – at a rate of 267 per 100,000 population compared with just 30 in Birmingham, where the water supply has been fluoridated since 1964.

He said fluoride benefits all social classes but its biggest benefits were for children from poorer families.

He accepted there was an ethical debate and that some insisted it was a fundamental right not to drink fluoridated water. ‘Well, I don’t agree,’ he said. ‘If we have a public water supply then we really have to make some compromises. If we all had the right to say what we wanted (in our water supply], we would really be talking about anarchy.’

And he claimed ‘There are some very strong views about fluoride but it’s certainly a minority view. People who by and large support fluoridation just think their health authority should get on with it.

Where the minority oppose, they oppose it with some degree of passion – but it is a minority view.’

THE CASE AGAINST FLUORIDATION

DR CONNET challenged Prof Lennon’s view and insisted it was important to examine the science that underpins the pro-fluoride lobby’s claims.

He presented plenty of statistics in support of his claims that fluoride was ‘not effective, not necessary, not safe and not ethical’.

Turning first to the ethical argument, he said: ‘We are allowing a local state or government to do to everyone what a doctor can do to no-one.’

He said it was ‘poor medication’ as you cannot control the dose – that would depend on how much water you drink – and there was ‘plenty of evidence’ that many people were being over-exposed to fluoride.

Dr Connett said the level of fluoride naturally occurring in mothers’ milk was 0.004 parts per million so that one part per million was 250 times more than nature intended.

He said its benefits worked from the outside of the body not the inside so drinking it ‘makes as much sense as swallowing suntan lotion’.

Querying whether fluoride was effective, he presented an array of research data which appeared to indicate that in fact there was no correlation between improved rates of dental health and the introduction of fluoride.

‘Dental fluorosis rates are very clearly related to fluoride but reduction in dental decay is not,’ he said.

He argued fluoride can cause serious health problems, potentially damaging bones, the brain and the endocrine system and that there was an ‘inadequate’ margin of safety to protect the very young, the very old, those with poor diet, poor kidney function or iodine deficiency.

‘This is a reckless public health policy,’ he concluded.

QUESTIONS FROM THE AUDIENCE

FOLLOWING the presentations, questions were invited from the audience.

Father of two young boys, James Osborne said he believed education was the key to persuading youngsters not to drink sugary drinks. ‘I don’t think we need mass medication, I think it’s flawed.’

Health Minister Eddie Teare stood up to insist: ‘Contrary to opinion, this isn’t a predetermined policy. What we are doing is gauging public opinion.’

Walter Graham, spokesman for Northern Ireland Councils against Fluoridation (Ulster voted ‘no’ to fluoride in 1996), argued: ‘It really doesn’t make any sense at all.’

He claimed that 40 per cent of water is lost in leaks and of the 60 per cent left, industry uses seven eighths and of the eighth that’s left, all but one per cent is used for washing or flushing the toilet.

Pharmacist Hilary Costain asked what other options there were to reduce the high levels of dental decay and Dr Connett suggested looking to the examples of others countries such as Scandinavia where zilotol toothpaste is widely use to prevent oral bacteria from thriving.

Standing up to announce he would have to leave the meeting, which by then had been going more than two hours, Prof Lennon said: ‘Dr Connett and I can bat this forward and back all night and we will never come to any conclusion. I’m convinced fluoride is safe and effective. I hope you in the Isle of Man can come to an equitable solution.’

As he was leaving a head count of those for and against was taken with just three – Prof Lennon, Dr Kishore and Minister Teare – voting in support of fluoride.

Whether the vote indicated that opponents of fluoride are far from a minority or whether it merely showed that the anti-fluoride lobby made up the vast majority at the meeting is perhaps another argument that can batted back and forth.