Can putting fluoride in water solve Hull’s teething problems?

Hull West MP Alan Johnson
Hull West MP Alan Johnson
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“You would think we were trying to poison them from the way they talk.” The debate on fluoridating water supplies in Hull is hotting up. Alex Wood reports.

IN A CLINIC off Beverley Road in an area of Hull where tooth decay is rampant, dentist Amir Mohagh demonstrates how fluoride can be a “fantastic” help.

43 per cent of five-year-olds have decay in Hull, compared with 28 per cent nationally.

British Dental Association

Dr Mohagh daubs some pleasant-tasting gunky paste from a small tube onto my teeth and assures me it will stick.

The high-concentration “fluoride varnish” which he has used thousands of times on young children in his 25-year career can do wonders, he says, reversing early decay, and can have a beneficial effect in older teeth too.

But when it comes to adding it to the city’s drinking water supplies he - and he is not alone - is not convinced.

The chair of Hull’s health and well being board Coun Colin Inglis is backing plans - with the support of former Health Secretary and local MP Alan Johnson for fluoridation of supplies at one part per million, citing the city’s parlous record in tooth decay in young children.

The British Dental Association says 43 per cent of five-year-olds have decay in the city, compared with 28 per cent nationally. But there’s is already a vociferous campaign against. Anti-fluoride protestors joined trade unionists in a demonstration outside the city’s Guildhall last week and hundreds of signatures have been added to petitions.

Campaigners say it increases fluorosis which leaves white spots on the teeth, or in severe cases, brown mottling. It has been linked to bone cancer and hip fractures and most recently to weight gain and depression.

The University of Kent suggested there was a spike in the number of cases of underactive thyroid in high fluoride areas such as the West Midlands and the North East of England after comparing records from nearly 8,000 general practices.

Researchers said: “Consideration needs to be given to reducing fluoride exposure, and public dental health interventions should stop (those) reliant on ingested fluoride and switch to topical fluoride-based and non-fluoride-based interventions.”

Dr Mohagh concurs: “I am not convinced that it will benefit people because the side effects might be far more than we think they are.

“Secondly if people don’t want fluoride in their water where do they get it from? I believe more research is needed to justify fluoridation.”

He feels the problem lies squarely at the door of parents who don’t bother making sure their children’s teeth are brushed. And he feels mass medication is an assault on basic freedoms: “I don’t want to have fluoride in my water; you have to give people the choice, because John and Harry have decay, why punish me?”

Clearly an issue that inflames local opinion, Coun Inglis has already found himself on the receiving end of a stream of emails from those who are outraged by the proposals.

He points out it is early days in a process which will take at least three years and has no certainty of success.

It took five years after NHS chiefs first proposed to add fluoride to the water supply in Southampton only for the plans to be abandoned, despite being endorsed by Public Health England and a High Court ruling last year.

In Hull, Coun Inglis’s board has taken the bold step of deciding to put away £100,000 a year towards the £300,000 capital costs of the equipment, which will be needed in the water treatment works.

Running costs at between £80,000 to £100,000 a year are an extremely efficient use of money, argues Coun Inglis for the health benefit it will deliver: “There is absolutely no doubt about it, it will have a significant effect on dental health, reducing the number of bad teeth by 40 per cent without doing anything else at all.”

Coun Inglis says he has never yet come across a dentist who disagrees with fluoridation, citing the support of both the local dental committee - who originally approached him via Alan Johnson - the local medical committee, as well the British Dental Association, the British Society of Paediatric Dentistry and the British Medical Association.

Unfortunately he says, most politicians are eventually persuaded, not by the strength of the scientific arguments, but by the howls of protestors.

And he says it will be difficult to have a rational argument about fluoridation “because there are too many people who are not prepared to look at the evidence and experience of people like Birmingham (where it was introduced 50 years ago) and accept it.”

He added: “A dentist said to me that anybody who oppose fluoridation should hold down a screaming child while they apply general anaesthetic to remove most of their teeth.

“General anaesthetic is applied more frequently to children in Hull having decayed teeth removed than any other reason.

“A significant proportion of children don’t go anywhere near a dentist. I have to deal with reality - people don’t take the children to the dentist and don’t make them brush their teeth. There are significant costs arising from that when a child has to have their rotten teeth fixed.”

This, however, has not stopped “emails from all sorts of people saying it’s an outrage - you’d think we were adding strychnine to the supply the way some of them talk.

“They say ridiculous things like it is poisonous. The people of Hartlepool are not dropping down dead because their water is fluoridated at one part per million. The bottom line is that Public Health England is not there to damage health.

“Their review of evidence which was published last year is absolutely clear. They recommend fluoride and say it has no negative effects whatsoever.”

The British Dental Association’s scientific adviser Professor Damien Walmsley, said: “While there is much scaremongering about the supposed ill-effects of fluoridation, there is no evidence that at the level used in the UK that fluoridation harms health, and it is positively beneficial for healthy teeth.

“A comprehensive review into the safety of fluoridation by Public Health England just last year provided further reassurance that water fluoridation is a safe and effective public health measure.

“PHE found no differences between fluoridated and non-fluoridated areas in their rates of hip fracture, osteosarcoma (a form of bone cancer), cancers overall, Down’s syndrome births or all-cause mortality (all recorded causes of death).”

Around the world come 372m people drink fluoridated water.

While Australia provides fluoridated water for some 70 per cent of its population, and more than four in five of the US’s largest cities add fluoride, some Canadian cities, including Calgary, have stopped adding fluoride in recent years. And despite criticism, Israel stopped adding fluoride to its water supplies last year, citing concerns about the health impact of excessive consumption.