Page 26 - What Doctors Don't Tell You - AU-NZ (February-March 2020)

NEWS FOCUS

Water fluoridation Cochrane, the research body Fluoride facts
considered an impartial arbiter of
is an intervention scientific data, found evidence that • Small children often swallow 50 percent of

of its time, but with fluoridation reduces dental decay—there the toothpaste on their brush, ingesting up to
was a 35 percent reduction in decayed
increased awareness, and missing teeth in children who lived 1.5 mg of fluoride
that time has passed in fluoridated areas—but the reviewers • All toothpastes with fluoride are supposed to
were concerned that the 20 studies they carry a poison warning in the US
analyzed were old, with small numbers of • Almost all the fluoride in our body is in our
6
children and high risk of bias.
MedicalUniversityinChinatook Researchers at Notre Dame University- teeth and bones
anotherlookat26studies,involving Louaize in Lebanon also aren’t sure. • Despite the myth, fluoride doesn’t help
7,258children,andconcludedthathigh Water fluoridation can be essential in protect bones affected by osteoporosis; in
fluorideexposureinwaterwasstrongly poor communities, but the fact that fact, it increases the chances of fracture
linkedtolowerintelligencelevels. 3 modern toothpastes and mouth rinses
OtherChineseresearcherscarriedout contain fluoride should be enough to • Fluoride was introduced into public water
asimilarexerciseandcametothesame prevent tooth decay today, they say. 7 supplies in 1945 with the promise that dental
conclusions.Theyreviewed27studies It’s not as if we’re going to run out decay in children would halve. It did—
thathadcomparedIQscoresacross of fluoride. It’s a form of fluorine, the although the rate had already started to drop
regionswithdifferentfluoridationlevels thirteenth most abundant element in the in 1930
andnotedthattherewasaconsistent earth’s crust, and it occurs naturally in • By 2004, fluorosis—a discoloring of the
differenceinthescoresofchildrenliving water and soil. Every time we drink tea or
inareaswiththehighestandlowest eat seafood that includes edible bones or teeth from excessive fluoride ingestion—was
fluoridelevels. 4 shells, we’re ingesting fluoride—and, of affecting 41 percent of American adolescents
ResearchersfromtheUniversity course, we’re doing it every day when we • Almost all research into the effectiveness of
ofKentintheUKwentfurther, brush our teeth with most toothpastes. fluoride in water was done before 1980
concludingthat“fluoridehasthe It’s not a nutrient—although it was
potentialtocausemajoradversehuman heralded as such by dentists in the • Just 10 percent of the world’s population has
healthproblems”—andhasonlya 1950s—andsothere’snorecommended fluoridated water
“modest”impactondentalhealth.The dailyallowance(RDA)forfluoride;
fluoridationofpublicwatershouldbe insteadthere’san“adequateintake”that products. A single strip of toothpaste
reconsidered,theysay. 5 variesdependingonwhetheryou’rean contains up to 1.5 mg of fluoride, and
adultorachild,manorwoman. mouth rinses have 0.25 mg.
Notsomodest Theadequatedailydoseforachildis Even when public water is fluoridated
Theirlastpoint—thatfluoridehasonly 0.7mg,butFluorideActionNetwork,an to the new, lower level of 0.7 ppm,
amodestimpactinpreventingtooth anti-fluoridationgroup,argueschildren dental fluorosis, a disease caused by
decay—isstillhotlydebatedbythepro- getfarmorethanthateverydaywhen an overabundance of fluoride, affects
andanti-fluoridecamps. theybrushtheirteethoruseotherdental around 12 percent of children, and
that figure will be higher in areas
Thetopfluoridenations Countrieswiththemosttoothdecay where fluoride levels are higher, say the
Cochrane researchers.
COUNTRY % FLUORIDATED COUNTRY AVERAGE* FLUORIDE STATUS
Water fluoridation may indeed have
Hong Kong 100 Norway 1.7 None
been one of the top 10 most important
Singapore 100 Japan 1.7 None health measures in the twentieth century,
Brunei 95 New Zealand 1.4 63% coverage especially in an age before the affluence

Australia 80 Iceland 1.4 None we enjoy today, but with increased
Chile 70 Greece 1.35 None wealth, awareness of a healthier, low-
sugar diet, and the abundance of fluoride
Malaysia 75 Finland 1.2 None
toothpastes, it’s an intervention of its
Irish Republic 73 USA 1.19 64% coverage time, and that time has passed.
Israel 70 Italy 1.1 None Bryan Hubbard
United States 64 Ireland 1.1 73% coverage

Guyana 62 Australia 1 80% coverage REFERENCES
Source: British Fluoridation Society, 2012 *Averagenumberofdecayed,missingorfilledteethin12-year-old 1 EnvironInt,2019;105012
children.Source:WorldHealthOrganizationDMFTindex 2 JAMAPediatr,2019Aug19
3 PublicHealth,2018;154:87–97
No cause-and-effect between fluoride and tooth decay: Three countries—the US, Ireland and 4 EnvironHealthPerspect,2012;120:1362–8
Australia—rank among the top 10 for both water fluoridation (left) and tooth decay (right). All in 5 ScientificWorldJournal,2014;293019
6 CochraneDatabaseSystRev,2015;(6):
all, there appears to be no correlation between whether a nation fluoridates its water and citizens’
CD010856
dental health. Other factors such as diet and lifestyle are more likely to be involved. 7 PrevNutrFoodSci,2018;23:171–80

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