Fluoride: friend or foe?

Once hailed as the enemy of tooth decay, fluoride now has as many detractors as advocates. So should it be added to our children's drinking water?

There is a widely held belief in this country that fluoride is good for teeth and, as a consequence, it is added to the water supply throughout the UK. In fact, Scotland, Wales and Northern Ireland are fluoride-free and only about ten per cent of us have it added to our water.

Fluorosis and children
Pressure groups, such as the National Pure Water Association, point out that, far from being regarded as a health boon, fluoridation is banned by law in Sweden and Holland and most of the EU is fluoride-free. They also believe there are a number of health concerns, particularly for children, connected with fluoridation, including, ironically enough, a dental disease called fluorosis. This is a condition resulting from excess fluoride in the body that causes structural damage to the surface of the adult teeth before they have erupted. The results are, at best, unsightly, with yellow and brown staining but can also lead to pitting and a gradual loss of enamel. There is no cure except a lifetime of expensive and painful cosmetic dentistry.

Ireland is the only country in the EU where fluoridation is mandatory and 73 per cent of the population have it added to their water. Irish dentist Don MacAuley says: 'As a result of fluoridation over 40 per cent of my patients suffer from fluorosis. The tooth disfigurement that results from fluorosis mostly affects the developing adult teeth. These teeth develop underneath the baby teeth in the jaw. The fluoride damages these unerupted teeth and disturbs the forming enamel. This typically occurs from infancy to six to eight years old. Therefore, when the adult teeth come through the gum, the damage has already occurred.'

New findings
Fluoride seems to be less effective in reducing tooth decay than was previously thought. The government's own York Review in October 2000 found that in fluoridated areas 48 per cent of the population suffered from dental fluorosis, with a reduction in dental caries of only 14.6 per cent. So, while fluoride may prevent dental disease in less than a sixth of the population, it causes dental disease in around a half.

Babies are particularly vulnerable. According to Professor Hardy Limeback, Professor of Dentistry at the University of Toronto, 'Children under three should never use fluoridated toothpaste. Or drink fluoridated water. And baby formula should never be made up using fluoridated tap water.'