Recent media coverage about an alleged dramatic increase in dental decay amongst children being the result of lack of fluoride fails to take into account several factors which, we feel, are important.
The New Zealand Academy of Oral Medicine and Toxicology, a professional body of dentists and physicians affiliated with the International Academy of Oral Medicine and Toxicology (www.iaomt.org), deplores the recent supposedly authoritative statements in the media, puporting to endorse both the safety and the need for municipal water fluoridation.
Our members and those of the International parent organisation, consider them to be grossy inaccurate and misleading. Since the data supporting the claim about a dramatic increase in dental decay has not been published, it is not possible to verify its accuracy but fluoridation promoters claim that a dramatic increase in dental decay amongst children has been caused by a lack of fluoride, mainly in the water supply. The scientific validity of that assertion is highly questionable.
Firstly: The theory that fluoride is the main factor in reducing dental decay is unproven This theory is presently not supported by the available NZ epidemiological evidence. In a 1998 paper by Betty De Liefde published in the NZ Dental Journal it has been demonstrated that:
i) There has been little valid statistical difference over the past 10 years between fluoridated and non-fluoridated areas with both showing identical falling incidences.
ii) A controlled field trial of topical fluoride showed no benefit.
iii) Most of the benefits of fluoride tablets could be explained by other dentally beneficial practices.
iv) The conclusions of many fluoride mouth-rinsing studies are now questioned because historical base-line data… can give the illusion of benefit.
v) Attempts to attribute all the changes in caries prevalence to fluoride divert attention from other investigations.
vi) NZ epidemiological evidence of change in prevalence does not correlate well with the timetable of the introduction
This paper published in NZ Dental Journal, the main dental journal in this country, therefore seriously questions the often stated theory of fluoride’s primordial role in the prevention and reduction of dental decay.
Secondly: Dietary considerations must take precedence as a root etiology of dental decay.
The early Maori population would have had rampant decay if dental decay was a fluoride deficiency disease. However, only 1:2,000 teeth ( 0.05% ) showed any decay in hundreds of skulls examined in the 1930’s by Dr. Weston Price, a Past President of the American Dental Association. Weston Price showed that within one generation and even between siblings, the incidence rose to 25-40% decay after they adopted the European foods of commerce based on white flour and sucrose. Dentists are seeing decay in infants who are being malnourished, who have had injudicious multiple courses of antibiotic syrups, who are regularly being given high sucrose containing drinks and foods, and/or who have inherited defective teeth due to mineral deficiencies in previous generations. This is known in Veterinary Medicine e.g. rampant dental disease was eliminated in NZ sheep in the 1960’s by the simple addition of selenium. Similarly, rats only developed caries after being fed sucrose directly into the stomach (intubation), thus bypassing the oral cavity.
Other factors such as stress and urea imbalance have also been involved. Thus it is widely proven and accepted in informed scientific circles that sucrose and it’s derivatives are the primordial factors in dental decay. A public health campaign to raise public awareness on this issue would go a long way in improving oral health while being eminently more desirable and safer than mass medication through the water supply.
Thirdly: Mass medication through the addition of fluoride to the water supply has ethical and medical consequences that cannot be ignored. Recent scientific research has established a link between fluoridation and potentially serious adverse health effects such as neurotoxicity and osteotoxicity.
Post-menopausaul women and the elderly are at increased risks of fractures, as well as increased toxicity in those with cardio-vascular and renal diseases. Increased exposure and accumulation of fluoride and aluminium is a definite possibility unless the amount of exposure can be closely monitored and controlled through individual medication. The presence of fluoride in many home-use dental products, in the water supply and in the food supply as a result of industrial activity is well established. As a consequence there has been a significant increase in dental fluorosis. When the risks of central nervous system disturbances are considered, the alleged dental benefits of water fluoridation become less appealing especially if those alleged benefits are not supported by the available epidemiological evidence. The intellectual capital of our youth is a most precious asset that must be protected and enhanced.
There are therefore several significant factors that could influence the apparent rise in dental decay in the Western Bay area. Based on recent scientific evidence we consider that the simplistic theory of water fluoridation as a safe and highly effective means of caries prevention and reduction, lacks scientific merit, is fraught with potential health hazards and is unwarranted for a large proportion of the public even if of some localised dental benefit.
According to the U.S. Agency for Toxic Substances and Disease Registry (ATSDR, 1993), large cohorts of the public will be at considerable risk of adverse health effects from this procedure. To quote from the Toxicological Profile for Fluorides, Hydrogen Fluoride and Fluorine (p 112): “Populations that are unusually susceptible: & the elderly, people with calcium deficiency, magnesium and vitamin C deficiencies, and people with cardiovascular and kidney prob-lems” ( a large percentage of the population). This statement and numerous other research papers in our files, reveal a significant lack of safety that has also been documented by overseas University researchers.
In November 1999, Professor Limeback, Head of Preventive Dentistry, University of Toronto, President of Canadian Association of Dental Research, and the country’s leading fluoride authority, publicly apologised to his faculty members and the media for mistakenly promoting water fluoridation for over 15 years.
His apology included the following,” Skeletal fluorosis is a debilitating condition that occurs when fluoride accumulates in bone making them extremely weak and brittle. The earliest symptoms are mottled and brittle teeth. In Canada, we are now spending more on dental fluorosis than we do treating cavities.” He added, ” Dentists have absolutely no training in toxicity. Your well- intentioned dentist is simply following 50 years of misinformation from public health and the dental association. Me, too. Unfortunately, we were wrong. Poisoning children was the furthest thing from my mind.”
M.E. Godfrey, M.B, B.S, FACAM, FACNEM.
J. Imbeau, D.M.D, FACNEM (Dent.) President NZAOMT IAOMT Representative to the New Zealand Chapter