I AM surprised that Professor Michael Lennon, chairman of the British Fluoridation Society, feels he has to attack me personally rather than focus on the issues surrounding water fluoridation and am not sure why he states that I “stoop to new depths”.
My concern is that there should be open debate and, far from “denigrating eminent colleagues”, I expressed disappointment that the vice president of the Faculty of Public Hearth, did not provide a more balanced picture of the facts. In response to Professor Lennon, my “cause” is to ensure the good use of evidence to promote ethically sound public health policy.
In his Soapbox piece, Professor Lennon chooses to focus on dental fluorosis but ignores much of the latest evidence on its extent and impact. At fluoride concentrations of 1ppm, as advocated for Southampton, a study in 2000 conducted in Newcastle found that 54 per cent of eight to nine year olds experienced some level of dental fluorosis.
While it is correct to state that most fluorosis produces a pearlised or white flecking, it is widely accepted that a proportion of affected children will experience brown staining and possible damage to the enamel of their teeth. Indeed, the most recent systematic review on fluoridation in Australia puts the estimate of fluorosis of more than aesthetic concern at ten per cent with other studies showing the more severe forms averaging between two and three per cent.
Research has consistently shown that adolescents with brown staining report negative views about their appearance and a 2006 UK study found that young people viewed dental fluorosis more negatively than dental decay.
It is not just about teeth – dental fluorosis is an indicator of fluoride absorption in the body. Evidence suggests that increasingly many people, particularly young children, are in danger of exceeding accepted safe limits of fluoride intake.
While the British Fluoridation Society has a mission to extend and promote water fluoridation – including through misinformation for which they have been criticised in Parliament -my concern is that we do not simply follow a policy based on evidence that is recognised as being of poor quality.
Our common goal should be to ensure that the people of Southampton are supported in attaining good dental health through effective community based and targeted measures as has been achieved elsewhere.