Public Meeting - Water Fluoridation

[ballaughbiker]

Fair enough saveourwater, just wondered. It was really the fella from Yorkshire on last week's mannin line that got me thinking. There was no way he just happened to be listening to MR and had all the arguments at his fingertips. However, like everyone else here he was just airing his views, which is good, in fact essential to this sort of debate.

 

Pressure groups are by their nature self appointed which does not make their views fact. However, you wouldn't think that listening to some of them! The only qualified person on last weeks program was the dentist who appeared to think tooth decay was a thing of the past. I sincerely wish it was, but that is not the case in the real world (a fact, not an opinion).

[saveourwater]

I guess the local dentist was only expressing his own professional experiences. He said that he did not see the ‘rampant’ decay that was being reported by the government figures. If I remember correctly he said that he has two practices on the Island and has been practicing for over twenty years, and that during that time he has seen caries prevalence amongst children attending his practices decline significantly.

 

We have also had this same comment made to our group from other members of the dental profession from all over the Island.

 

We do however accept that dental caries (although apparently on the decline) is still a problem and that something needs to be done about it. We have suggested that a better solution to fluoridation may well be a sustained programme of education and other preventative measures – a route Scotland recently chose to follow instead of fluoridation.

 

We see little evidence of much else being tried on the Island, and only one option on the table as a solution.

 

If the dental system is faulty then it needs to be changed, but change will only come about when the dental community organise and lobby for change. To have funding cut, NHS contracts made unattractive and to force people into a corner with fluoridation as the only escape route is in our view unacceptable.

[ballaughbiker]

I believe an education and prevention program was started in the schools in the early 90s but there is only so much you can do. When the kids go home they do what they like. The big problem with dental education is that there is a huge lag between cause and effect. Sorry, I don't want to state the obvious put if you put your hand in the fire it hurts straight away. If you burn holes in your teeth by eating and drinking sugary acid sweets and pop it doesn't hurt straight away but years later. Ok, us adults can work that out but not a five year old.

 

It would be interesting to know how many general anaesthetics are being done here each week to take out kids teeth damaged by caries. Does anyone know? if there is more than 1 or 2 (there most likely will be) that somewhat blows the argument of "dentist from all over the island" suggesting that tooth rot is no longer a problem. It just doesn't add up does it?

 

What are the figures of dental disease over the past five years and how does this compare to the uk? I've looked on the net but can't find any reference to it. If we had the figures in front of us we could all speak referring to facts instead of guesswork. I think I said before, the government could not be accused of using fluoridated water to replace dental services. It would take 25 years before big inroads could be made in the demands and needs of young patients. However they and future generations would benefit for all of their lives.

 

It is a fact (that I know antis on here don't agree with by quoting a nutty professor) that the best time for teeth to start absorbing fluoride is birth. The first molars which come through at 6 start to calcify at birth. Waiting until its proved that a child was soft teeth, its too late and too ineffective to then toally rely on prevention. The only way to get fluoride absorbed at birth is to have it in the water, that's real prevention There's the dilemma. I want that benefit without restricting peoples right to chose. Difficult isn't it?

[saveourwater]

You might have a point if it were not for the following: -

 

Fluoridation has never been proven safe or effective.

 

Fluoridation has not been proven to combat ‘baby bottle’ decay which is the kind of decay often depicted in pro-fluoridation propaganda.

 

Due to high risk of developing dental fluorosis many people now state not to use fluoridated water for the first year of life (including the American Dental Association and the US Centre for Disease Control), but as you state this is the period that fluoridation is ‘supposed’ to have most benefit i.e. before the teeth erupt, so what is the point?

 

Fluoridation is uneconomical in that more than 99 pence in every pound goes (quite literally) down the drain as we consume much less than 1% of water produced for drinking. Surely all that wasted money could be better spent. It is also interesting to note that it would be illegal to pour the raw chemical straight down the drain – yet that is exactly where more than 99% of it ends up!

 

Fluoridation is unethical, it denies the right to choose.

 

Fluoridation may be illegal on many counts, but until there is a judicial review this cannot be proven only speculated upon.

 

With fluoridation there is no way to control dosage. OK you can’t exactly drink masses of water without making yourself ill but what about total exposure to fluoride from all sources. Once the water is fluoridated it will be present in all local produce from bread and milk through to butter, cheese and beer. How many pints could you safely drink once the water is fluoridated? If you had drunk a few cups of tea (natural fluoride) and some water in the day could you safely drink any beer after work? Studies in the UK have shown that more than 20% of people living in non-fluoridated areas in the UK already ingest more than the UK governments ‘safe’ allowance. Although the World Health Organisation recommend that health officials carry out fluoride intake surveys in areas where fluoridation is being considered this has not yet happened on the Isle of Man, when asked if he knew how much fluoride people on the Island currently intake Dr Emerson said “I don’t need to know”.

 

There are links to adverse health effects. Fluoride is cumulative and stores in the body over time, these risks are real because the small daily dose gradually builds in the body to a level where problems can occur.

 

These are just some of the arguments. In reality tooth decay is a minor health problem that can be easily treated and better still prevented by education on diet and hygiene.

 

If some children are having trouble with brushing and diet the government can help them in other ways. This should be easy for them, children should be at school 5 days a week most weeks in the year. If the people in charge of dental health on the Island cannot locate and assist these children then their competence surely needs to be questioned.

[Ushtey]

What I find most interesting is a conversation I once had with a leading government health adviser who agreed that suppling schools with free fruit would be more effective than adding flouride to the water. This during a tour of one of the new water treatment works on the island.

[ballaughbiker]

You might have a point if it were not for the following: -

Thanks, here are my replies to your points:

Fluoridation has never been proven safe or effective.

Not according to the American Dental association who say"Cavities used to be a fact of life. But over the past few decades, tooth decay has been reduced dramatically. The key reason: fluoride. Research has shown that fluoride reduces cavities in both children and adults" Fluoride is like any other nutrient; it is safe and effective when used appropriately" It is not harmful at the optimum level of 1ppm.

Fluoridation has not been proven to combat ‘baby bottle’ decay which is the kind of decay often depicted in pro-fluoridation propaganda.

True however that's not the full story. For fluoride to be taken up in primary teeth it would have to be ingested before birth. It does cross the placenta but in limited quantities hence reduced efficacy. Bottle caries is caused by a truly huge sugar diet but I agree it is disingenuous for the profluoridationists to use these images to illustrate general caries

Due to high risk of developing dental fluorosis many people now state not to use fluoridated water for the first year of life (including the American Dental Association and the US Centre for Disease Control), but as you state this is the period that fluoridation is ‘supposed’ to have most benefit i.e. before the teeth erupt, so what is the point?

Agreed but this in the litigation mad USA. In reality fluorosis is not seen at 1ppm. If it was, it would be obviously linked with naturally fluoridated areas. It's not.

Fluoridation is uneconomical in that more than 99 pence in every pound goes (quite literally) down the drain as we consume much less than 1% of water produced for drinking. Surely all that wasted money could be better spent. It is also interesting to note that it would be illegal to pour the raw chemical straight down the drain – yet that is exactly where more than 99% of it ends up!

Not according to the ADA again "water fluoridation is an extremely effective and inexpensive means of obtaining the fluoride necessary for optimal tooth decay prevention," I agree that most will go down the drain but are you really saying 1/1000 of a gram in a litre constitutes "raw chemical"? Really?

Disease prevention by fluoridation isn't unethical, it denies the right to choose.[/b]

Fluoridation in itself isn't unethical but I agree everyone should have the right to choose.

Fluoridation may be illegal on many counts, but until there is a judicial review this cannot be proven only speculated upon.

I like the "maybe". You can say anything with a maybe in the sentence!

With fluoridation there is no way to control dosage. OK you can’t exactly drink masses of water without making yourself ill but what about total exposure to fluoride from all sources. Once the water is fluoridated it will be present in all local produce from bread and milk through to butter, cheese and beer. How many pints could you safely drink once the water is fluoridated? If you had drunk a few cups of tea (natural fluoride) and some water in the day could you safely drink any beer after work? Studies in the UK have shown that more than 20% of people living in non-fluoridated areas in the UK already ingest more than the UK governments ‘safe’ allowance. Although the World Health Organisation recommend that health officials carry out fluoride intake surveys in areas where fluoridation is being considered this has not yet happened on the Isle of Man, when asked if he knew how much fluoride people on the Island currently intake Dr Emerson said “I don’t need to know”.

Well he should know but it is not possible to overdose at 1ppm as it is impossible to drink enough water without more serious health effects from happening first due to the volume consumed"[/i]

 

There are links to adverse health effects. Fluoride is cumulative and stores in the body over time, these risks are real because the small daily dose gradually builds in the body to a level where problems can occur.

It is cumulative but there are no statistically significant heath differences between fluoridated and non-fluoridated areas. So what are these problems then?

These are just some of the arguments. In reality tooth decay is a minor health problem that can be easily treated and better still prevented by education on diet and hygiene.

It is a minor problem if you don't suffer from it! Seeing little children being gassed before 5 years old would change even your opinion on how minor this is. Caries prone people can have to endure a lifetime of pain, fear and expense. Is that minor? Tooth decay is one of the most preventable of all disease processes. Its immoral that we have the means to control it. ADA again "Unfortunately, many people continue to be misinformed about fluoride and fluoridation."

 

If some children are having trouble with brushing and diet the government can help them in other ways. This should be easy for them, children should be at school 5 days a week most weeks in the year. If the people in charge of dental health on the Island cannot locate and assist these children then their competence surely needs to be questioned.

Tooth rot can start way before school age but I agree more needs to be done to assist these kids. Unfortunately its an oversimplification to suggest its only the dentists responsibility. Most of prevention is done at home (or not as the case may be)

[saveourwater]

The latest scientific research has shown that ‘fluoride’ has greatest effect when applied topically. LINK

 

Canada and Ireland are lowering dosage from 1ppm to between 0.8ppm and 0.7 ppm. Dr Emerson seems to be retreating on the 1ppm also, as he mentioned 0.8ppm on the radio last week (for the first time).

 

Strictly speaking drinking a single glass of water containing fluoride at 1ppm may not do you any harm, but long term exposure at this level may well do you harm. LINK

 

The raw chemical will of course be diluted into the water supply. However if for every 100 tons of fluorosilicic acid that you put into the system more than 99 tons ends up down the drain it does not matter whether or not it has been diluted. A very neat trick to get rid of something very nasty whichever way you look at it.

 

I would argue that fluoridation is unethical. It is in effect a medication, it is added with the intention of creating bodily change and to treat a disease. That the authorities have not yet licensed it is the issue here, but it does fit the definition of a medicine and the legal status is being challenged.

 

In the UK they at least have the 2003 Water Act which does allow for fluoridation. Under current Manx law fluoridation is not allowed, yet DHSS are advertising fluoridation and urging people to lobby MHK’s in support of fluoridation – is that legal?

 

The 2003 Water Act also covers public consultations on fluoridation, yet this law is not in place on the Island.

 

I am not blaming dentists at all and would like to make that clear. If there is any blame it lies in policy and the people in charge of dentistry at government level. I agree that education needs to start as early as possible, preferably during pregnancy. It should be entirely feasible for the authorities to tackle the problem of caries without resorting to fluoridation. The Island has a relatively large health budget and a small geographical area, there should be no excuse. Children are seen many times by healthcare professionals before starting school and problems should be easily identified, but only if the right people look in the right places.

[ballaughbiker]

Topic v systemic - it works both ways actually. Not only is the fluoride ion taken up in the developing tooth (can be proved by section/analysis of teeth removed for orthodontic purposes) it is now thought to be present in saliva adding to the topical effect of water sloshing past the teeth on the way down. However in my opinion, the topical effect on its own can lead to a hard outer shell of enamel but leave deep fissures on the tooth unprotected where rot starts. The best effect is systemic from a very early age and a bit of topical thrown in. If water fluoridation did truly have a topical effect only this 'deep fissure' caries would occur in treated areas. It doesn't.

 

1ppm Didn't know about that reduction but its not a hugely significant decrease is it? There are many areas of the uk with naturally occurring levels of more than 1ppm and people living there have imbibed this for thousands of years. If your theory that cumulative effects could increase this to toxic levels, why have the aforementioned people not suffered from all your perceived ills of fluoride ingestion, thousands of years ago? They would have shown some symptoms before now, wouldn't they?

 

Allegation "its a medicine" If it was, nature has been applying this so called medicine in the areas noted above for a very long time and its attendant drug trials have been the longest ever. Ethical discussions can fill books but I think that the antis would like to make everyone think its a drug to exploit the old mass medication arguments.

 

Legislation As much as I believe that our legal and independent position should be upheld at all costs, you have to admit that it does produce certain anomalies which need fine tuning as time goes on. This is why the Data Protection Act here lagged the UK by a year or two and there are lots of other examples. At the moment your assertion is technically correct but only by default.

 

Patient education/Government policy I fully agree with what you say here. However I understand that whilst this looks good on paper,in practice it is not as easy as it sounds. We all know that smoking kills but we still do it. We know the heath risks of fat food, salt, sugar, excess alcohol etc etc but we still eat/drink it in excess. Patient education is essential but does not reach some of the most vulnerable. It should and if I was in charge, I should try harder but lets get real. Why are we still gassing little children in the 21stC to rip out rotten teeth? Its immoral and indefensible when a simple public heath measure would reduce it dramatically within a generation. I note your earlier post dismissed this very common disease as minor. I do not agree.

 

Regarding dental services, the IOM could have had its own system 15 or so years ago and I believe if it had, and it allowed clinical freedom with a reasonable income, we would not have seen the majority of practices withdraw from the NHS. Unfortunately, like many other examples it was easier to follow the UK. However, be clear about one thing, this would have cost a fortune which is probably the main reason the UK system was adopted.

 

 

Finally, do you agree with saturation advertising? For some strange reason I had MR on all day yesterday whilst working on the car. Every time the local news came on, the theory of the UK using the IOM as some fluoridation experiment was mentioned. Of course MR was just reporting what a third party had said but in such a way that it might be understood by some as an official and valid opinion. After hearing this about 10 times in one day I was beginning to believe it myself, then I woke up. Come on MR, you have a duty not to continually broadcast a totally unsubstantiated theory just because "someone" said it. Unbiased reporting? It might lead someone more cynical than me to wonder.....

[Ushtey]

On a slightly different note, where and how would they propose to apply the dosing? Someone might want to check there is actually room in the new treatment works for this kit (and all the associated safety equipment).

[tameelf]

how to they determine safe dosage

 

we drink it

we brush teeth at times with fluro toothpaste

we wash our hair

we bathe in it

we wash clothes in it

we absorb it through our skin

 

what may be safe at the pumping station cant be regulated in the home .

 

if its mass medication and the whole off the population are to recive it ill have mine in pill form please not a 24/7 drip feed

[nipper]

On a slightly different note, where and how would they propose to apply the dosing? Someone might want to check there is actually room in the new treatment works for this kit (and all the associated safety equipment).

Same method as adding that chloride stuff?

 

[saveourwater]

On a slightly different note, where and how would they propose to apply the dosing? Someone might want to check there is actually room in the new treatment works for this kit (and all the associated safety equipment).

 

Government have said that 'space' has been allowed for in both new treatment works for 'fluoridation rooms’.

 

The feasibility study states that Hexafluorosilicic Acid is the chemical of choice because it is cheaper and (cough) ‘safer’ (although a powdered form of this substance could be used as an alternative).

 

I believe that the method of dosage is computer controlled injection into the main as one of the last (if not last) stages before the water leaves the plant.

 

Government has also stated that no equipment has been put in place, and that this will not be done until the consultation has finished and a decision to fluoridate has been made.

[Ushtey]

On a slightly different note, where and how would they propose to apply the dosing? Someone might want to check there is actually room in the new treatment works for this kit (and all the associated safety equipment).

Same method as adding that chloride stuff?

 

 

 

Nope, would require a different delivery method, the chlorine is produced on site using salts, the chemical dosing areas have not been designed with flouride dosing in mind.

[Ushtey]

On a slightly different note, where and how would they propose to apply the dosing? Someone might want to check there is actually room in the new treatment works for this kit (and all the associated safety equipment).

 

Government have said that 'space' has been allowed for in both new treatment works for 'fluoridation rooms’.

 

The feasibility study states that Hexafluorosilicic Acid is the chemical of choice because it is cheaper and (cough) ‘safer’ (although a powdered form of this substance could be used as an alternative).

 

I believe that the method of dosage is computer controlled injection into the main as one of the last (if not last) stages before the water leaves the plant.

 

Government has also stated that no equipment has been put in place, and that this will not be done until the consultation has finished and a decision to fluoridate has been made.

 

Se my last answer but flouride wouldn;t have been included in the orginal design nor during early construction. The plans are a matter of public record, the designs were open to public scrutiny during the Tynwald inspection and a number of people have been given tours of the works as they were being built.

 

The final injection method may be water mix dosing, but the storage and handling of the Hex woudl still require increased safety measures, in bulk form it is poisonous, as are many chemicals. I imagine the people living close to the works would be interested in the safety measures required and what designs were originally included.

 

Depending ont he volume and the frequency of supplies to the Island, it could require a large volume of storage, I'd be surprised if there is much free space in the building to handle that, particularly at Douglas.

[pontiuspilot]

"The raw chemical will of course be diluted into the water supply. However if for every 100 tons of fluorosilicic acid that you put into the system more than 99 tons ends up down the drain it does not matter whether or not it has been diluted. A very neat trick to get rid of something very nasty whichever way you look at it."

 

F.A.O. SaveOur Water

from the above, if Disodium hexafluorsilicate needs to be disposed of there are far easier ways of doing it than this, again, you lack of subject knowledge is showing through.

the comment you keep making about it being a biproduct of something else is a red herring also. many chemicals are put to use this way. whole industries thrive on the fact that several different things can be made from one process. it is a very ecomnoical way of operating a chemical plant. this is the classic ICI model.

 

you are sounding a bit manic S.O.W.