Review of fluoridation science

Sir Peter Gluckman has released a review of scientific evidence on fluoridation.  It is a readable 67 page report and co-authored by the Royal Society of NZ.

Some useful extracts:

There is compelling evidence that fluoridation of water at the established and recommended levels produces broad benefits for the dental health of New Zealanders. In this context it is worth noting that dental health remains a major issue for much of the New Zealand population, and that economically and from the equity perspective fluoridation remains the safest and most appropriate approach for promoting dental public health.

The only side effect of fluoridation at levels used in NZ is minimal fluorosis, and this is not of major cosmetic significance. There are no reported cases of disfiguring fluorosis associated with levels used for fluoridating water supplies in New Zealand.

For the future:

Given the caveat that science can never be absolute, the panel is unanimous in its conclusion that there are no adverse effects of fluoride of any significance arising from fluoridation at the levels used in New Zealand. In particular, no effects on brain development, cancer risk or cardiovascular or metabolic risk have been substantiated, and the safety margins are such that no subset of the population is at risk because of fluoridation.

All of the panel members and ourselves conclude that the efficacy and safety of fluoridation of public water supplies, within the range of concentrations currently recommended by the Ministry of Heath, is assured. We conclude that the scientific issues raised by those opposed to fluoridation are not supported by the evidence. Our assessment suggests that it is appropriate, from the scientific perspective, that fluoridation be expanded to assist those New Zealand communities that currently do not benefit from this public health measure – particularly those with a high prevalence of dental caries.

There were five members of the expert panel, all professors in scientific fields. There were also three international reviewers from Australia, the UK and Ireland..

Tooth decay is responsible for significant health loss (lost years of healthy life) in New Zealand. The ‘burden’ of the disease – its ‘cost’ in terms of lost years of healthy life – is equivalent to 3/4 that of prostate cancer, and 2/5 that of breast cancer in New Zealand. Tooth decay thus has substantial direct and indirect costs to society.

That’s a stunning stat, I had not seen before.

Like many elements that affect human health, fluoride is beneficial in small amounts and toxic in excess. More than 500 years ago, the physician and alchemist Paracelsus first stated the basic principle that governs toxicology: “All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.” In other words, for substances that have beneficial effects on health, “the dose differentiates a poison from a remedy.” Fluoride clearly benefits dental health when used topically or ingested in small doses, but in very high doses it is poisonous, and has been used as a component of pesticides. Similar examples can be found among beneficial health promoting vitamins, including vitamin D, which in high doses is an effective rodenticide
used to eradicate rats and possums, and in humans can cause musculoskeletal and renal disease.

This is also a key quote to remember when the anti-brigade breathlessly go on about how fluoride is a toxin.