Fifty Years of Fluoridation: Part II
By Elizabeth A McDonagh, National Pure Water Association
Reprinted with kind permission of the Author
The Water (Fluoridation) Act (1985) was passed by the British Parliament on 30th October of that year. It legitimised (at the written request of health authorities) the fluoridation of water supplied by a water undertaker to one part per million (1 ppm). The chemicals allowed were hexafluorosilicic acid, H2SiF6, and disodiumhexafluorosilicate, Na2SiF6, but these could be amended by order of the Secretary of State.
Before implementing fluoridation a health authority had to publish details of its proposal three months in advance and give notice of its plans to local authorities in the districts affected. The health authorities were to have such regard as they consider appropriate to any representations made to them with respect to fluoridation and to any consultations held with the local authorities [Water (Fluoridation) Act (1985)]. According to Lord Monson, these amendments permitting a limited degree of local option were grudgingly conceded by the Government [Moolenburgh, 1987 (Foreword by Lord Monson)]. The well-known naturopath Dr Jan de Vries called the Act in fact an enormous step backwards in health care [Moolenburgh, 1987 (Introduction by Jan de Vries)].
On July 10, 1986, Diesendorfs paper, The mystery of declining tooth decay, was published in Nature. Over the previous thirty years, tooth decay had been declining substantially in both fluoridated and non-fluoridated areas of eight developed countries. Diesendorf explained why the documented improvement in childrens teeth could not be attributed to fluoridation (or even, in most cases, to fluoride toothpaste or tablets). He called for a scientific re-evaluation of all the studies alleging the benefits of fluoride as he considered those benefits might have been overestimated.
Diesendorf pointed out that the early studies were rather primitive. They could be criticised for the virtual absence of quantitative statistical methods, their non-random method of selecting data and the high sensitivity of the results to the way in which the study populations were grouped. Independent surveys in naturally fluoridated locations in India, Sweden, Japan, the U.S. and New Zealand did not bear out the early American results.
Ziegelbeckers well-designed attempt to analyse all published data on caries prevalence in naturally fluoridated areas found essentially no correlation between caries and log of fluoride concentration. Others have questioned fluorides value and the methodology of studies supporting it but these surveys are omitted from lists of studies on the role of fluoridation in caries prevention [Diesendorf, 1986].
Diesendorf did not mention the 1967 to 1970 study comparing Hartlepool (with 1.5-2.0 ppm natural fluoride in the water) with low-fluoride York (0.2 ppm) [Murray, 1971]. York had higher tooth decaybut all tykes born within 20 miles of that city remember with nostalgia the big brown-paper bags of factory misshapes proffered by their privileged schoolfellows whose parents worked in the chocolate trade.
The leading proponents of fluoridation in Britain are the Health Authorities and the British Fluoridation Society. They promote fluoridation (to 1 ppm) as a safe, cost-effective and desirable public health measure in the interest of a reduction in childhood caries. After all, no one would want to see a child suffer. They claim up to 50% reduction in caries in fluoridated as compared to non-fluoridated areas. The figures are sometimes based on the old North America studies, or otherwise on selected DMF rate comparisons from more recent local surveys. In a recent example, 50% represents an average difference of 0.84 of a tooth in the 5 year old group and 1.12 teeth in the 14 year olds [Thomas, 1996]. The fluoridationists point out that many communities already have one ppm of natural fluoride in their water and that many foods (especially fish and tea) contain fluorine. They deny that there is any scientific controversy over the issue, on the grounds that fluoridation has been approved by health authorities, the World Health Organisation and the British and American Medical and Dental Associationsand they tend to avoid face-to-face debate with their opponents.
Health Authorities seek to advance fluoridation by organising training sessions for doctors, dentists and other health professionals, publishing posters for display in surgeries and clinics, supplying speakers for groups (e.g., W.I., P.T.A., Round Table, Mothers Union), and sending non-technical promotional material to local councillors and water company officials. Puoridationists also lobby MPs and encourage toothpaste manufacturers to give prominence to the word fluoride in their advertising.
In autumn 1993, Its Only Water The FLUORIDATION PACK was trialed in selected schools. Participating teachers were offered an honorarium of 100. The Curriculum Pack carried the logos of Birmingham Health Education Unit and the British Fluoridation Society by whom it was said to have been funded. Intended for 14 to 16 year olds, it provided four 1 1/2 hour teaching units, two for science and two for english. Its bias was evident from page one where the U.K population was given as 55 million with only six million benefiting from fluoride. The experiment on page six (where one egg coated in fluoride toothpaste fails to dissolve in vinegar and a second uncoated egg dissolves) invites the conclusion that the fluoride has protected the egg by forming a protective layer and that this is analogous to the protection afforded to teeth by fluoride in the mouth [Birmingham Health/B.F.S., 1993]. Not everyone agreed that this was sound science and the National Pure Water Association published a hard-hitting three page critique of the curriculum pack [Gibson, 1994].
In a letter dated 26 July 1994 to Councillor Theresa Stewart, Leader of Birmingham City Council, the Health Education Adviser for Birmingham LEA admitted that All monies for the production of the pack and the honoraria to the schools . . . were paid for by the Department of Health through a grant to the British Fluoridation Society [Harvey, 1994]. Thus our youngsters can gain knowledge, develop beliefs and so influence the process of future public health policies [ibid.].
According to information from Companies House, in the year ending 31 March 1996, the British Fluoridation Society received grants of 121,306 from public funds, including 27,470 from the European Union. This fact, and the status of the Health Authorities as non-elected, Government-appointed agencies, leads to the inevitable conclusion that fluoridation is Government policy and that its promotion is being spearheaded by taxpayers money. Where fluoridation is adopted it is paid for out of the National Health Service budget.
Funding for anti-fluoride campaigns contrasts sharply with the affluence of the Health Authorities and the B.F.S. Travelling, organising meetings, consultations with scientists, politicians and water-company officials, preparation and printing of leaflets and reports has to be done on a tight budget. Much is achieved by bodies such as the National Pure Water Association who rely on voluntary subscriptions and donations. The work of some local groups is largely underwritten by coffee mornings, raffles and jumble sales.
Late in 1992, the Yorkshire Regional Health Authority initiated public consultations in advance of a planned request to Yorkshire Water PLC for fluoridation. When the Health Authority claimed public support, there were complaints from some Scarborough residents that they had been denied an opportunity to vote. It emerged that the Scarborough consultation had consisted of 200 people (in a town of 106,000) being asked the single loaded question Would you support adding fluoride to water supplies if it benefits childrens teeth? The resultant furore led to a (17 February 1993) newspaper poll to which there were over 800 respondents, 88% of whom voted NO. Yet the Scarborough Evening News reported that North Yorkshire Health Authority had received 1118 letters in favour of fluoridation and only 229 against. The Health Authority was expected on these grounds to claim that 80% of Scarboroughs residents supported fluoridation [Scarborough Against Fluoride, 1994].
Scarborough Against Fluoride requested sight of the letters and it transpired that many had been sent by health professionals (some of whom were members of B.F.S.) from outside the district. Contact with anti-fluoride groups in other parts of the County revealed further anomalies and that some individuals had sent multiple letters. A full investigation was impossible because some district health authorities would not allow public scrutiny of the consultation process or reported that their letters had already been shredded [ibid.].
Some local councillors and whole councils had declared their opposition to fluoridation, but it became apparent that the Health Authorities intended to ignore the opinion of elected representatives [Scarborough Against Fluoride, 1994]. Meanwhile, a large number of customers wrote to Yorkshire Water PLC to protest against fluoridation. The company received few letters in favour [Personal telephone conversation with Dr. Shuttleworth of Yorkshire Water PLC]. Christine and Jeff Brook-Smith, the Scarborough couple who have turned anti-fluoride campaigning into an art form, presented a report of their findings to the water company and alerted their Member of Parliament [Scarborough Against Fluoride 1994].
On Friday March 10, 1995 a spectacular sand sculpture took shape on Scarborough beach as Jeff worked all day in a biting wind to create the 40ft Truth Fairy threatened by a massive ogre. Designed to catch the attention of Liberal Democrats meeting for their Spring Conference, the sculpture attracted considerable interest from the public and the press, appearing in glorious technicolor on the front page of the Yorkshire Post the following morning [Yorkshire Post, Saturday 11 March 1995]. In April, Yorkshire Water PLC, having listened to their customers and fearful of litigation and the risks inherent in storing toxic chemicals at their treatment works, announced their decision not to fluoridate.
At a fringe meeting of the Lib-Dem Conference, Dr. Peter Mansfield, President of the National Pure Water Association, described the toxicity of fluoride as between that of lead and arsenic. One of his child patients had become ill after swallowing toothpaste. There was no NHS facility for monitoring physiological fluoride levels, so Dr. Mansfield devised his own and began testing patients. In many cases, after withdrawal of sources of fluoride, urinary output of fluoride fell and clinical symptoms improved. Dr. Mansfield concludes that many people, in both fluoridated and non-fluoridated areas, suffer from low-grade fluoride poisoning. Fluoridation of water simply adds to the problem [Mansfield, 1995]. The National Register of Children with Dental Fluorosis records over three hundred children whose teeth are permanently mottled through excessive fluoride intake. Mottling is the earliest sign of chronic fluoride poisoning. Manufacturers now produce childrens toothpastes with lower fluoride levels and toothpaste packets carry warnings against using too much or swallowing the product [National Register of Children with Dental Fluorosis].
In Fluoride: The Great Dilemma, Waldbott lists the major symptoms of fluoride toxicity which he names CHRONIC FLUORIDE TOXICITY SYNDROME [Waldbott, 1978]. These are:
Chronic fatigue not relieved by extra sleep or rest
Dryness of the throat
Frequent need to urinate
Urinary tract irritation
Arthritic-like pains in lower back, jaw, neck and limbs
Tingling sensations in fingers (especially) and feet
Gastrointestinal disturbances (pain, diarrhoea, constipation, bloating, tenderness)
Loss of mental acuity and ability to concentrate
Tendency to lose balance
This list, compiled in 1978, exactly parallels the symptoms of M.E.
Throughout 1995, the National Pure Water Association (N.P.W.A.) was very active, informing politicians and health professionals of recent Danish research. The Danish studies conclude that, in some individuals, fluorosis occurs at any exposure level and exposure to too much fluoride during tooth development can cause weakening of the teeth through hypomineralisation. If fluoride has a cariostatic effect, it is only when oral pH is ?5.5. A plasma fluoride concentration of 0.02 ppm (500 times less than the fluoridation optimum) is sufficient and is readily obtainable from sources other than water [Fejerskov et al 1994].
N.P.W.A. asked almost 60 leading fluoridationists for a personal statement that fluoride is A) safe and B) effective, that they would produce proof of the safety and efficacy and that they would take personal responsibility for any harm suffered by individuals. Needless to say, not a single reply was received [N.P.W.A.1995]. The Association also collected statements from pro-fluoridation texts, Government publications and medical textbooks as evidence that fluoridation is unsafe and ineffective. 25.000 was offered to the first person who could show that any of these statements was untrue but no-one has claimed the money [N.P.W.A. 1996].
N.P.W.A. is pressing for repeal of the Water (Fluoridation) Act (1985), the Northern Ireland Water Fluoridation Order (1987) and detachment from the Water Industries Act (1991) of two clauses of its Section 87. It is pursuing the ethics of mass medication without consent and asking for a judicial review on all aspects of fluoridation. There is fear that the Government will scrap the public consultations altogether or will make fluoridation mandatory on the water companies. N.P.W.A. is therefore continuing its political campaign in the hope that fluoridation will become an issue for the forthcoming General Election [personal communication].
On January 4, 1996, the Evening Standard ran an article New fluoride water plan for all of London [Revill 1996]. Health authorities in the Capital (and in Northern Ireland, Anglesey, Boston, Lincs, Worcester and the North East) were again demanding fluoridation.
The Government hopes to fluoridate Northern Ireland in advance of next years planned privatisation of the provinces water supply. Of the twenty-six local councils in Ulster, 25 have voted against the measure. Malcolm Moss MP, Minister for Health and Environment in the province, is expected to make a final decision before the end of this year. Meanwhile schoolchildren in Lurgan have been doing experiments with eggs and toothpaste.
Opposition to fluoridation is said to be the one issue that unites all parties across the sectarian divide. One theory being bandied about in Northern Ireland is that fluoride (like its fellow halogen, bromide) makes a population submissive to authority [McCrystal 1996].
This idea is not new. Moolenburgh relates how, in 1971, he received a paper containing a bizarre and unbelievable story. It told of an American chemical engineer called Perkins who was seconded to the staff of a chemical works in Germany on the conclusion of World War II.
Perkins was said to have been told that the Nazis had developed plans to put fluoride into the water of the occupied countries because, by affecting a particular part of the brain, the chemical caused the recipients to become more docile [Moolenburgh 1987 pp 51-52].
Moolenburgh was unable to corroborate this crazy story which, he said, was widely regarded as poppycock by both the proponents and opponents of fluoridation. However, on checking a 1985 medical reference book he discovered that 25% of the major tranquillisers are connected with fluoride. I do not draw any conclusions. The only thing one can say at this point is, with Alice, curiouser and curiouser [Ibid.].
At the A.G.M. of Yorkshire Water PLC on July 25th, the writer asked whether the new board fully supported the Companys stated no fluoridation policy (of April 1995). The reply was that the matter was under review. The Truth Fairy had not been sleeping.
Scarborough Against Fluoride had held another bric-a-brac sale and produced another report [Scarborough Against Fluoride, 1996]. This document was presented to the Green Network International Conference on Human Health and Toxic Chemicals held at Warwick University, 26th 28th July, 1996. A workshop on the subject resulted in almost unanimous support for the principles set out by the N.P.W.A.and Scarborough Against Fluoride. As a result, the Conferences Declaration on Food and Healthy Living, to be presented to F.A.O.s World Food Summit in Rome in November, includes a call upon all governments and international agencies at the World Food Summit to end the addition to water of any substance not required for its treatment but intended to affect the physical or mental functions of water consumers [Green Network, 1996].
In the immortal words of Ralph Nader:
Egads, what a subject! Youre either for it or youre against it. If youre for it youre a public health hero. If youre against it youre considered a kook [Gotzsche, 1975].
DMF rate. The average number of decayed,missing and filled teeth in a population, usually related to a particular age-group.
References to Fifty Years of Fluoridation: Part II
BIRMINGHAM HEALTH EDUCATION UNIT/BRITISH FLUORIDATION SOCIETY (1993)
Its Only Water The FLUORIDATION. PACK
Martineau Education Centre, 74, Balden Road, Birmingham. B32 2EH
DIESENDORF, M (1986) The mystery of declining tooth decay Nature 322 : 125-129
FEJERSKOV, O, LARSEN, M.J., RICHARDS, A, BAELUM, V (1994)
Dental Tissue Effects of Fluoride Adv. Dent. Res.(June) 8 (1) : 15 31
GIBSON, S (1994)
Its Only Water The FLUORIDATION PACK and Fluoride FactsComments
N.P.W.A., 17, Sycamore Lane, West Bretton, Wakefield. WF4 4JR
GOTZSCHE, A-L (1975) The Fluoride Question Davis Poynter Ltd., London
GREEN NETWORK (1996) DECLARATION on Food and Healthy Living
Green Network, 9, Clairmont Road. Lexden. Colchester Essex CO3 5BE
HARVEY, J (1994) Letter to Cllr. Theresa Stewart, Council House, Birmingham B1 1BB July 26
from J. Harvey, Health Education Adviser, 74, Balden Road, Birmingham. B32 2EH
MANSFIELD, P The First Hundred Clients and (1995) Letter to Hon. Martin Redmond M.P. July 5
Good Healthkeeping, Middlegate, Manby, Louth, Lincs. LN11 8EB
McCRYSTAL, C Orange and Green unite to fight a yellowing peril The Observer 22 September 1996 : 7
MOOLENBURGH, H (1987) Fluoride, The Freedom Fight. Mainstream, Edinburgh.
MURRAY, J J (1971) Effects of fluoridated water on dental health Brit.Dent.J. Nov 2
N.P.W.A. (1995) Leading fluoride pushers decline NPWA Challenge Watershed November
(1996) 25,000 Reward Unclaimed! Watershed August
12 Dennington Lane, Crigglestone, WAKEFIELD WF4 3ET
NATIONAL REGISTER OF CHILDREN WITH DENTAL FLUOROSIS
Home Farmhouse, Oxton. Notts. NG25 0SZ
REVILL, J New fluoride water plan for all of London. Evening Standard 4 January 1996
SCARBOROUGH AGAINST FLUORIDE (1994) Report on public support for fluoridation and
(1996) Report on a Silent Killer
10, Church Street, Scarborough. North Yorkshire. YO11 1RL
THOMAS, N (1996) Water fluoridation and dental health Doncaster Health News May 9 : 2
WALDBOTT, G L (1978)
Fluoridation The Great Dilemma Coronado Press, Lawrence, Kansas. USA: 392-393
WATER (Fluoridation) ACT (1985) H.M.S.O.
YORKSHIRE POST (1995) Photograph of The Truth Fairy sand sculpture March 11 : 1