After nearly 23 years as a GDP, the fluoride argument refuses to disappear. It seems neither side is easily capable of rational, non-emotive discussion – the lines are drawn in the sand, and the drums of war sound again. To fluoridate or not to fluoridate, that is the question.

What if both sides could look at the evidence with fresh eyes, without prejudice? The scientific evidence regarding the efficacy of topical fluoride is proven beyond dispute. The recent DOH guidelines rightly state that fluoride is a natural element, but what is actually being added to our water?

The answer is sodium fluorosilicate and fluorosilicic acid. To my amazement, it is not a pharmaceutical grade chemical, but a waste product of the phosphate fertiliser and mining industries. In this state, it is not natural and far from pure, with impurities including lead, arsenic and cadmium. Maybe, finally, we could commence checks on fluoride levels among the general population to help eradicate fears – no health agency in fluoridated areas is monitoring F exposure or possible side effects. It has somehow slipped behind the medical radar.

Did you know that fluoridation is practised in only 3% of Europe? Israel is the latest country to stop [mandatory] fluoridation. An ongoing court case in Ireland, the only European country with mandatory fluoridation, is looking to ban it on health grounds. What other medication is provided on a one dose fits all regime? With dental fluorosis affecting a large number of Kiwi children, what is this doing to their bones? To their brains? Most SSRI drugs, such as Prozac, are largely fluoride based. A recently published review by the US Harvard School of Public Health concluded the IQ studies showing brain impairment needed to be taken seriously, the results remarkably consistent. Fluoride has now been reclassified as a developmental neurotoxin, in the same category as lead and arsenic.

How does fluoride work? Recent evidence would suggest that benefits are largely topical, so why do we need to ingest it? What other sources now contain fluoride, apart from dental products? Another surprise – it is in breakfast cereal, fruit juice, milk, cola, meat etc , so what is a safe dose and just how much are we getting?

Maybe, just maybe, we need to reconsider all of the facts, all of the options. Maybe it is time to draw a line in the sand and begin again- a fresh approach. Maybe it really is not as black and white as both sides would have you believe – according to WHO data, most Western industrialised countries have rejected water fluoridation yet experienced the exact same decline in childhood decay. Non-fluoridated Scotland is experiencing far greater improvement in children’s decay rates than that obtained through water fluoridation.

With an argument that rages on, why do I feel so nervous to raise these questions amongst my valued and respected colleagues and friends?

By Dr Laurence Fisher