The Poor and Fluoride Toxicity |
Dental health is improving, so why do we need fluoridation?
BFS suggested answer
Over the past 25 years or so tooth decay rates have improved largely due to the widespread use of fluoride toothpastes and greater awareness of sugar in the diet. However, the improvement has been greater among the more affluent and inequalities in dental health have widened – except where water supplies are fluoridated.
In non-fluoridated Glasgow for example, the single most common reason for children under the age of 10 needing a general anaesthetic is for tooth extraction. In the poorest parts of non-fluoridated Liverpool 1 in 3 young children have had teeth extracted before the age of 5. In Birmingham where the water has been fluoridated for 35 years such statistics are now unheard of.
Water fluoridation gives poor kids rich kids’ teeth!
BFS suggested answer refuted
Poor, malnourished children, especially infants, are the most sensitive barometer of fluoride toxicity.
Dr Albert Schatz
In Britain and Ireland today, it is recognised that the poor are at greater risk of suffering from decayed teeth. The UK government’s Saving Lives: Our Healthier Nation states:
Poor people are ill more often and die sooner. To tackle these fundamental inequalities we must concentrate attention and resources on the areas most affected by air pollution, poverty, low wages, unemployment, poor housing, crime and disorder, which can make people ill in both body and mind.
Dentists and health authorities are particularly anxious to target fluoride at areas of poverty, as it is among the poorer elements of society that the highest incidences of tooth decay are found. Unfortunately, evidence has shown that a good diet is essential if one is to mitigate the adverse effects of fluoride. People who have less than adequate diets – ‘the poor’ – are just the people who are most likely to be damaged by the very fluoride that is supposed to help them.
Children are the most susceptible to adverse health effects caused from the ingestion of chemically treated water. Children from families with good incomes suffer less from adverse health effects like dental fluorosis, while children from lower-income families are more likely to suffer adverse health effects.
Using instances of dental fluorosis as an indicator, poor children have 2.3 times as much fluorosis as children from higher-income families.1 This ratio suggests that the toxic contaminants associated with fluorosilicic acid would also affect children’s health to a similar degree. The reason for the disparity between economic brackets is nutrition: good nutrition provides enough minerals and vitamins to help the body counteract the adverse effects of fluoride.
Fluoride is of no benefit to the poor in England . . .
The BFS rightly makes the point that poor children tend to have a worse dental record than children in wealthier families. But that is the point they conveniently ‘forget’ when they compare decay rates in different towns. Any meaningful result requires comparisons between children with similar socioeconomic profiles within fluoridated and unfluoridated areas. It is no good comparing, for example, children from wealthy families living in a fluoridated area with children from poor families living in an unfluoridated area, and then claiming that the better teeth of the ‘rich kids’ are due to the fluoride. Yet, in comparing Glasgow and ‘the poorest parts’ of Liverpool with Birmingham, that is exactly what the BFS has done.
The amount of deprivation in an area, and thus the number of poorer children, is measured by the ‘Jarman score’, or UPA (underprivileged area) score. The higher the number, the more underprivileged it is. Let us try another comparison, this time between Liverpool, a northern seaport on the west coast of England, and Gateshead, a northern English seaport on the east coast:
•Based on the 1991 census, Gateshead’s UPA score is 14.75, while Liverpool’s is 34.69.2 Thus, Liverpool’s children are poorer, and one can expect that Liverpool children’s teeth will have more decay.
•Gateshead’s children drink artificially fluoridated water at the ‘optimum’ 1 ppm; Liverpool’s water is not fluoridated. If fluoride helps teeth, as the BFS claims, this, again, should mean that Liverpool children’s teeth should have more decay.
But this is not the case. The rates of dental caries in Liverpool and Gateshead, as measured by the British Dental Association, are identical: 5-year-olds have an average of 1.85 carious teeth in both cities.
. . . or in the USA
A survey of 39,000 children living in fluoridated, unfluoridated or partially fluoridated communities was conducted by the National Institute for Dental Research in 1986–87.3 Although it cost US taxpayers $3.6 million, the data from this study were suppressed. Nevertheless, Dr John Yiamouyiannis managed to pry the data out of the NIDR by using the Freedom of Information Act and, from the data, was able to show that there was a difference of less than half a tooth in DMFT values.
Is that enough to compensate for the stigma of stained teeth caused by dental fluorosis? Or the other more serious health effects? According to Dr Hardy Limeback, head of preventive dentistry at the University of Toronto, fluoridation of water ‘has contributed to the birth of a multi-billion dollar industry of tooth bleaching and cosmetic dentistry. More money is being spent now on the treatment of dental fluorosis than what would be spent on dental decay if water fluoridation were halted.’4
Tooth decay is down – where nutrition is better
As was discussed in Chapter 1, the tooth decay rate has gone down in both fluoridated and unfluoridated communities all over Europe and America. It is not because of fluoride, and it is not because we are eating less sugar. The reason decay rates are declining is because we are eating more protein than our malnourished ancestors did, and we are focussing on dental hygiene as a social requirement. But high-protein foods – meat, fish, dairy products – are more expensive, and the poor are less able to afford them. So they survive largely on bread and potatoes, while their children, more than most, are comforted with sweetened dummies, sweets, colas: all the things that increase decay rates.
Studies from other parts of the world confirm this – and it has been known for a long time. In 1952, the Journal of the American Dental Association told its readers:
The higher index of mottling in Italy may be explained on the basis of differences in nutritional status . . . The data from this and other investigations suggest that malnourished infants and children, especially if deficient in calcium intake, may suffer from the effects of water containing fluorine while healthy children would remain unaffected.5
Maury Massler, professor of pedodontics at the University of Illinois College of Dentistry, warned that ‘low levels of fluoride ingestion which are generally considered to be safe for the general population may not be safe for malnourished infants and children, because of disturbances in calcium metabolism’.6
Conclusion
What makes the efforts to fluoridate us all so pernicious is that they are being promoted in the name of protecting the poor. Yet it is well understood among fluoride researchers that it is precisely those who are malnourished, and consequently are likely to be the poor in our society, who are most vulnerable to, and most adversely affected by, fluoride’s toxic effects.
Far from water fluoridation giving poor kids rich kids’ teeth, as the BFS suggests, it seems that the opposite is true: fluoridation gives rich kids poor kids’ teeth.
1.Taber, CW. Taber’s cyclopedic medical dictionary, Philadelphia, F.A. Davis Co., 1994.
2.1991 UPA scores by 1996 Health Authority boundaries. Division of Primary Care and Population Health Sciences, Imperial College School of Medicine. http://www.med.ic.ac.uk/df/dfgm/upa/download.htm. Accessed 14 July 2000.
3.Yiamouyiannis JA. Water fluoridation and tooth decay: Results from the 1986–87 national survey of US schoolchildren. Fluoride 1990; 23: 55–67.
4.Limeback H. International Fluoride Information Network Bulletin No. 3. Available from ggvideo@northnet.org.
5.Relation of endemic dental fluorosis to malnutrition. J Am Dent Assoc 1952; 44: 182.
6.Should Natick Fluoridate? A report to the town and to the board of selectmen, Natick Fluoridation Study Committee. Natick, MA, 23 October 1997. http://www.cadvision.com/fluoride/natick.htm. Accessed 8 April 2000.