Should fluoride be added to the water supply in Southampton?

SOUTHAMPTON'S Primary Care Trust is considering adding fluoride to Southampton's water supplies after figures showed that 47 per cent of five-year-olds in the city had decayed, missing or filled teeth. The figure has risen by ten per cent in the last two years, despite efforts to tackle the problem through oral health promotion programmes. Now in a controversial move, the Southampton City PCT has agreed to ask health authority bosses to co-ordinate feasibility studies for fluoridating the water before a public consultation takes place. Here, the Daily Echo presents views from both sides of the argument.

CASE FOR fluoridation by Dr Andrew Mortimore, director of public health for Southampton City Primary Care Trust and Stella Saunders, consultant in dental public health.

CHILD dental health in Southampton is poor, with almost half of the city's five-year-olds having decayed, missing or filled teeth.

Over the past 12 years, the local NHS has invested hundreds of thousands of pounds into oral health promotion campaigns, including providing toothbrushes and fluoride toothpaste and promoting healthy eating.

Despite this, surveys of five-year-olds carried out in 1992, 1998 and 2002, show that the picture is getting worse, with them now having an average of two decayed, missing or filled teeth. More than 4,000 decayed teeth were removed from the mouths of Southampton's children last year.

And the problem doesn't just lie with our children. Many adults suffer from dental problems, which isn't helped by an increasing number of "dental phobic" adults who seek help.

Recruiting more dentists isn't an answer either. What the PCT wants to do is reduce dental problems, so you don't have to visit the dentist as much. We don't want you, or your children to suffer pain and sleepless nights, so it's time to look at alternatives.

Fluoridation is the single most effective public health measure for preventing tooth decay and improving oral health over a lifetime, as areas such as Newcastle and Birmingham have shown.

This is why Southampton City PCT recently made the decision to give local people the choice to decide whether they would like to supplement the fluoride that already naturally appears in their water, so that it can benefit the health of their teeth.

The process begins now. The PCT has asked Hampshire and Isle of Wight Strategic Health Authority to begin a feasibility study to see whether this is a viable and cost effective option.

If it is, then there will be a full, open and honest consultation with the people who live and work in Southampton, to ensure they understand all of the facts.

It's interesting to note that when the health authority went through this process 12 years ago, 78 per cent of people said they wanted fluoride added to their water.

During this process you will hear arguments for and against fluoridation. Fluoride is not a medicine, so adding it to the water is not a way of mass medicating or poisoning you. The chemicals used for water fluoridation are specifically manufactured to meet very high quality standards, and must meet Department of Environment purity specifications, which are constantly monitored by the government.

As for the ethical argument, drinking fluoride-free water is not a basic human right, but a question of individual choice, as is smoking, drinking alcohol, exercising, or fast food. It is a question about weighing up personal preferences against the common good.

What we will do is provide you with information about fluoridation and opportunities to have your questions answered, to enable you to tell us what you think. Fluoride will not be put into Southampton's water unless local people want it.

CASE AGAINST FLUORIDATION by Ann Richards, chairman of Hampshire Against Fluoride

Health authorities tell us that fluoridation is a safe and a highly effective means of preventing dental decay in children.

They look upon it as an economic way of reaching children who eat and drink too many sugary foods, who fail to clean their teeth and whose diets are low in essential minerals. They also hope to lessen the need for NHS dentists.

However, we pay to have water delivered to us in as pure a state as possible. It should not be interfered with in any way except using means to keep it potable.

Few people, including I suspect dentists, realise that hexafluorosilicic acid, the prescribed fluoridation chemical, is an impure industrial waste product coming, usually, from the superphosphate fertiliser industry. This substance has never been tested on humans for safety nor has it been licensed for use as a medicine.

Our government and many of those serving local health authorities have, however, chosen to ignore the library of international scientific studies showing that fluorides are implicated in a long catalogue of serious health effects including: thyroid malfunction, gastrointestinal trouble, liver problems, joint, tendon and muscle problems, osteosarcoma in young men and hip fractures in the elderly.

Dental fluorosis (a mottling and staining of the teeth) occurs in approximately half of the children living in fluoridated areas and about 15 per cent of those cases are serious.

Fluorosed teeth are a common sight in the fluoridated Midlands. This staining is a sign of systemic poisoning and is far from being the "purely cosmetic effect" claimed by fluorodistas.

Major dental researchers now concede that applying fluoride directly to the teeth is far more beneficial than drinking it. Moreover, the worst tooth decay in the United States occurs in poor city neighbourhoods fluoridated for some 60 years. Except for Ireland and parts of the UK virtually all of Europe has turned its back on the practice. Notably in those countries where fluoridation was tried and then discontinued it was found that the overall health of their children's teeth continued to improve.

Above all fluoridation is unethical and bad medicine. If we accept it, we lose our right to informed consent to medication.

The usual practice of a one-to-one relationship with our doctor or dentist in which we are diagnosed and treated according to our individual needs goes.

In the words of Dr Peter Mansfield: "No physician in his right senses would prescribe for a person he has never met, whose medical history he does not know, a substance which is intended to create bodily change, with the advice: 'Take as much as you like, but you will take it for the rest of your life because some children suffer from tooth decay.' It is a preposterous notion."

WHAT DO YOU THINK?

Should Southampton's Primary Care Trust add fluoride to the city's water supplies? Contact the Daily Echo at Newspaper House, Test Lane, Redbridge, Southampton SO 16 9JX or e-mail newsdesk@soton-echo.co.uk

You can also vote in our poll at the foot of the 'This is Southampton' homepage.