Many of us put our trust in the chemical fluoride as safe and effective weapon in the fight against tooth decay. In parts of the UK, water supplies come with fluoride already added, and dentists here have recently called for this practice to be made more widespread. However, the British enthusiasm for fluoride is not shared in other parts of Europe. The Belgian government has recently outlawed the sale of fluoride tablets and chewing gum, and many European countries have said a flat no to the addition of fluoride to their water supplies. It turns out that while many British dentists are keen to promote the benefits of water fluoridation for our teeth, this practice is not as scientifically rooted as we have been led to believe.

Dental decay remains a relatively common problem, and one that individuals are understandably keen to avoid. From a nutritional perspective, there is evidence that a diet low in sugar and refined starches, but rich in unprocessed plant matter such as salad ingredients helps to protect our teeth from decay. In addition to these tooth-friendly fundamentals, dentists are often keen to extol the virtues regular brushing and the use of fluoride too. While we have been adding fluoride to our water for the past 40 years, it is well recognised that quality of the original studies into this practice left a lot to be desired. Recently, a large review of the scientific literature on water fluoridation was published in the British Medical Journal. The results of this research, commonly referred to as the York study, have eroded some dentists’ confidence in the practice of water fluoridation.

As expected, the authors of the York study conceded that that rationale for water fluoridation is based on weak scientific evidence. In addition, the study found that just one in six people drinking fluoridated water appears to benefit from this practice – far less than previously thought. Not only that, but almost half of individuals drinking fluoridated water at permissible levels exhibit a condition known as dental fluorosis – a mottling and discoloration of the teeth caused by fluoride toxicity. Some dentists have questioned the wisdom of preventing dental disease in one in six people, only to cause it in one in two.

In Ireland, where 70 per cent of the water supply is fluoridated, there has been mounting opposition to the practice. Many parties are not just citing the lack of evidence of clear benefit, but also potential health risks posed by the unmonitored ingestion of a potentially toxic chemical. The recent Belgian ban on fluoride was based on fears that they might increase the risk of osteoporosis. Some have also raised issues about the ethics of water fluoridation, claiming that this is essentially mass medication without consent. It is sobering to note that almost all European countries have rejected water fluoridation including Germany, Belgium, Sweden, Italy, Denmark, Holland and France.

Personally, I’m less concerned about fluoridated toothpastes and mouthwashes on the basis that the doses of fluoride are more measured and little of this is likely to be ingested. However, I do think there are very real medical and ethical question marks over the practice of water fluoridation. Yet, in the face of these, the British Dental Association has recently urged the Government to expand the proportion of people in the UK receiving fluoridated water from 10 to 25 per cent. The dental establishment may be keen to see more of us having fluoride piped into our homes, but my advice is; don’t swallow it.

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