Fluoride: forming a view

Chatting to a client the other day, the conversation turned to a subject I know to be controversial. I won't feign a view I don't hold but sometimes it is best to avoid a subject rather than clash with someone for whom I am, for the time being, working. Referrals are good too, and less likely to come from someone I have recently disagreed with. 

As it happens the subject in question was fluoridation of the water supply - a subject on which I do not have a view.

This, I thought, is something which needs to be remedied; not the fluoridation of the water - my lack of a viewpoint. So I have been doing a bit of reading. It seems that like many topics, there are as many arguments as there are participants in the conversation. There have certainly been a lot of studies undertaken and the conclusions reached are spread across the spectrum of possible positions.

The only demonstrable benefit of putting fluoride in a community's water supply is a probable reduction in dental caries (tooth decay) amongst the population. On the other hand it can be shown that there are potential risks in terms of toxicity to certain persons of the added fluoride, nothwithstanding that it can also be shown that there are no risks. Depends which study you look at.

This is looking like a fairly even argument, which is why some authorities (I'm talking worldwide here) choose to fluoridate their water supply and others do not.

It has been said that in order to reach the teeth of the stratum of society which might benefit most from it, the fluoride should be added to soft drinks rather than drinking water. That point leads to the argument that protecting the teeth of children who do not clean them should be the responsibility of parents rather than the local authority. 

I can see some weight in that argument.

Iodised table salt has been a success story in reducing iodine deficiency and the illnesses which arise from it - goitre is one of them - I remember learning about that in geography lessons. I recall it being predominantly a third world condition.

Interestingly, fluoride can be added to salt a lot more cheaply than it can be added to water, and maybe would hit more of its target demographic when conveyed in that medium. Of course this has been tried and the results are as varied as might be expected.

So - do I have a view yet?

Water fluoridation was big news in the early 20th century, particularly in the US, and perhaps its persistence today has more to do with momentum than sense.

There is ample information available in all societies where fluoridation of the water supply might feasibly occur to enable parents to ensure the dental health of their children - should that be a priority for them.

Therefore I think my view is this: It is not the responsibility of the local authority to add fluoride to the town water supply.

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