Sir, thank you for printing Dr Connett's letter regarding fluoride.1
Recent publicity around unacceptable levels of child GA exodontia and the development of the (welcomed) Starting Well Programme, targeting prevention at the 13 areas in England with the worst child dental health, make the letter highly relevant.
There is simply no credible evidence that fluoride is neurotoxic at the concentrations used in community water fluoridation or those occurring naturally in areas like Hartlepool of between 0.7 and 1 ppm. There is, however, an international consensus that fluoridation at this level is safe and effective. It really is this simple.
The language used by Dr Connett is typical of the anti-fluoridation lobby. Words such as neurotoxic, toxic, fearful, chemophobia are designed to elicit an emotional response and to intimidate – even when there is zero evidence to support the points made. To an extent this approach has worked, successfully intimidating dentists and politicians even in the face of the scientific evidence that fluoridation can make a difference and is safe. There are signs that this is changing with the realisation that, in spite of the improved evidence-based prevention being delivered by GDPs in primary care, problems remain and fluoridation could help to change this.
It really is time that science and evidence is allowed to make the case for and against fluoridation. Recent reports2,3,4 from New Zealand, Australia and here in the UK state resoundingly that fluoridation is safe and reduces dental disease. As dentists, we need to demonstrate leadership, talk to our patients and local politicians and advocate fluoridation, particularly in communities where the dental health burden is high and where dental health inequalities are wide. It is time that the facts around fluoridation are allowed to speak for themselves – to use Dr Connett's own words – to protect the health of citizens.
Connett P . Water fluoridation: Is fluoride chemophobia? Br Dent J 2017; 222: 323–324.
The Royal Society of New Zealand. Health effects of water fluoridation: A review of the scientific evidence. A report on behalf of the Royal Society of New Zealand and the Office of the Prime Minister's Chief Science Advisor. August 2014. Available at: http://royalsociety.org.nz/assets/documents/Health-effects-of-water-fluoridation-Aug-2014-corrected-Jan-2015.pdf (accessed April 2017).
NHMRC. Draft Information Paper: Effects of water fluoridation on dental and other outcomes. September 2016. Available at: https://consultations.nhmrc.gov.au/files/consultations/drafts/nhmrc-fluoride-information.pdf (accessed April 2017).
Public Health England. Water fluoridation. Health monitoring report for England 2014. Executive summary. March 2014. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/300201/Water_fluoridation_health_monitor_for_England_2014_executive_summary_1Apr2014.pdf (accessed April 2017).
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Hull and the East Riding of Yorkshire LDC. Water fluoridation: It really is this simple. Br Dent J 222, 644 (2017). https://doi.org/10.1038/sj.bdj.2017.383