From the letters page of The Probe [Dental Trade] Magazine:

‘Alarmist’ fluoride reports undermine efforts

YOUR news feature on fluoride (Fluoride: Are opinions changing? December 2001) reports that Dr Vyvyan Howard has 'selected various papers which he claims establish that fluoride and, by implication, water fluoridation, is neither safe nor effective in reducing tooth decay rates. 

The University of York Centre for Reviews and Dissemination's systematic review of the safety and benefits of wafer fluoridation [1] is a far more reliable source of evidence - not least because it looked at all the evidence and so avoided the possibility of bias in selection of studies. The review concluded that water fluoridation is effective in reducing tooth decay and no evidence of a link with cancer, bone fractures or other adverse effects was found. 

The most recent survey of UK 5-year-olds highlights, yet again, wide inequalities in dental health [2]. Young children living in socially deprived, non-fluoridated areas continue to suffer unacceptably high levels of tooth decay. 

We are disappointed that The Probe has, on this and other occasions, been prepared to publish articles on fluoride and fluoridation which are, frankly, alarmist and do much to undermine the profession's efforts to improve the dental health of the most vulnerable children.

IAN WYLIE, Chief Executive, British Dental Association.

SHEILA JONES, MPH Co-ordinator, National Alliance for Equity in Dental Health.

REFERENCES

NHS CRD (2000): A Systematic Review of Water Fluoridation. Report 18, University of York. Also available on-line at http://www.york.ac.uk/inst/crd

Pitts NB, Evans DJ, and Nugent ZJ (2001): The dental caries experience of 5-year-old children in Great Britain. Surveys coordinated by the British Association for the study of Community Dentistry in 1999-2000. Community Dental Health; 18:49-55

An alternative viewpoint from fluoride.org.uk (NB. This does not form part of the letters page article in The Probe):

1. York Review

2. Fluorosed teeth counted as "sound and present" and Pictures of dental fluorosis

Author’s response:

The overwhelming majority of dentists, myself included, are convinced of the benefits of fluoride. However, this view is not universal - the Fluoride Awareness Day featured in the report was chaired by Dr Tony Lees, a general dental practitioner from the West Midlands. Surely The Probe would be failing in its duty to provide impartial news coverage if it restricted its content solely to views which are most widely held in the profession. 

DERRICK GARWOOD, BDS

Editor’s comment: 

I note your comments regarding our report of the fluoride awareness day, however, I'm afraid that I cannot and will not take the stance of ignoring all fluoride-related issues which may or may not seem controversial. 

As a dental newspaper, The Probe would be failing in its duty if I, as editor, chose to shy away from issues which challenged the majority opinion. 

Derrick Garwood’s article was purely a report of an open meeting. It did not call for new recruits to the ‘anti-fluoride brigade', nor did it in any way imply that everyone reading the report should immediately denounce fluoride. It did, however, feature the views of qualified dentists, who - whether or not you agree with their line of thought - are just as entitled to their opinions as you or I. 

I fail to see how allowing the profession to read a report of a meeting will “undermine the profession's efforts to improve tire dental health of the most vulnerable children". Surely, the pro-fluoride professionals amongst us will not be swayed by the publication of an impartial report. I certainly do not consider the views of those opposing fluoride to be at risk from those reports regarding effective, fluoride-containing dental products, regularly featured in both The Probe and its sister magazine The Hygienist. 

The Probe is a newspaper for the dental profession. That dental profession, like it or not, comprises a whole variety of opinions. Dr Rynne's challenge to the Irish Government over its fluoridation policy is a newsworthy issue - therefore, it warrants coverage. 

On the other hand, if anyone reading this knows of any forthcoming pro-fluoride events or newsworthy pro-fluoride issues, please do be sure let us know. As a dental newspaper, The Probe would be most interested in reporting on them.

REPLY [Published in the Probe, April, 2002]:

Re: ‘Alarmist’ fluoride reports undermine efforts (The Probe, Feb., 2002) 

As a member of the so-called ‘anti-fluoride brigade’, I would like to criticise some important points made in a letter to The Probe which was published in February and was signed by both Sheila Jones (wearing her ‘NAEDH’hat) and Ian Wylie (BDA). 

Jones’ and Wylie’s first line of defence is the ‘York Review’. This review has been criticised by numerous analysts who have taken the trouble to more closely examine the findings of the Review body [1]. Their contention that the York Review is a more reliable source of information is misleading. The York Review did NOT look at “all of the evidence” because it deliberately omitted all biomedical and animal studies BEFORE it began to qualify anything else. The York Review also DELIBERATELY refused to consider other factors which affect dental health statistics [2]. This I know personally because I was very much involved in this issue. I should also add that the claim that fluoridation reduces tooth decay was based on very bad evidence [3] and is easily disproved. If this was not enough, Professor Sheldon (Chairman, York Review Panel) has previously and publicly ‘slapped-down’ the pro-fluoride lobby (the BDA, the British Fluoridation Society [BFS] and the NAEDH) for misrepresenting the findings of the Review [4]. I would therefore humbly suggest to Messrs. Wylie and Jones not to skate on thin ice. 

The second defence was the use of the BASCD’s ‘dmft’ statistics which are used by the BFS (Sheila Jones again) in the form of ‘league tables’ to promote fluoridation. Forgive me if I am wrong, but I cannot recall any mention of these ‘league tables’ in any of the York Reviews research or findings, probably because they are unscientific. In fact, they are often used as a propaganda tool to mislead vulnerable audiences. Again, I have personal experience of these shenanigans. 

Finally, I would like to say that if the stories about the dangers of fluoride are considered to be “alarmist”, then perhaps they should be seriously investigated before they are criticised (such as the MMR vaccine controversy). The establishment (read Blair Government) and state-sponsored [5] organisations like the BFS are only interested in propagandising, being hyper-sensitive to criticism or close scrutiny, and not taking seriously the important research which gives rise to such ‘alarmist’ claims. 

References: 

[1] York Review Index

[2] Critique: C Holdcroft

[3] Brief Analysis of the York Review

[4] Commons fluoridation debate 29th Jan 2001

[5] ..\..\infodocs\f12.htm

Yours sincerely,

C Holdcroft, http://www.fluoride.org.uk