Professors slam change to water fluoridation policy

Academics rebuke Health Minister Yael German’s decision to cancel mandatory adding of flouride to drinking water.

By JUDY SIEGEL-ITZKOVICH
Tapline reservoir at Snir Nature Park 390 (photo credit: Doron Nissim/INPA)
Tapline reservoir at Snir Nature Park 390
(photo credit: Doron Nissim/INPA)
Two of the country’s leading professors of community dentistry disputed Health Minister Yael German’s claim that approved levels of fluoride consumed in drinking water can cause thyroid disease in chronically ill patients or harm to pregnant women.
Prof. Harold Sgan-Cohen and Prof. Jonathan Mann of the Hebrew University Dental School’s Department of Community Dentistry said, “According to all mainstream, professional and scientific data from around the world and within Israel, fluoride in general and in water specifically, is the most efficient, cheapest and safest measure of dental health promotion that reaches across the socio-economic spectrum.”
Last week, German signed a law that will make fluoridation by the local authorities optional and not mandatory except in very low-population locations.
In her previous position as mayor of Herzliya, the minister had additionally objected to fluoridating all water supplies when children are mainly the ones to benefit.
On Wednesday, German replied to the professors’ objection to her policy in a letter, saying that the new regulations, setting water quality and not requiring fluoridation, will take effect in a year.
She insisted that it was better to provide fluoride in other ways to “target audiences” such as poor children, who were unlikely to brush their teeth regularly with fluoride toothpaste.
“It must be known to you that fluoridation can cause harm to the health of the chronically ill and pregnant women,” German wrote in the letter.
She argued that only 2% of water is used for drinking by the population, with the rest used for dishwashing, bathing, industry and other uses.
Ministry public health officials have privately been grinding their teeth over German’s decision, as the ministry has for decades endorsed fluoridation. Ministry director-general Ronni Gamzu publicly said that he will have to find other ways to deliver fluoride to specific populations who need it.
The Hebrew University professors said, “We strongly support water fluoridation and believe that the idea of the health minister to potentially stall [within a year] the continued national fluoridation project is an immense error.”
“A recent study conducted in Israel, among a representative sample of 2,181 children, clearly demonstrated that water fluoridation is dramatically associated with diminishing and even eliminating social inequalities in dental health, especially among low socioeconomic communities,” the professors said.
“This is, therefore, a classic example of social justice in action. Since the initiation of water fluoridation in Israel, our research has clearly revealed a significant decrease in dental caries. Every effort should be made not to arrest this positive trend and this highly important achievement.”
The professors continued that “as academic public health dentists, based on our knowledge, experience and research, we believe that this potential policy shift would constitute a huge disservice to the public. There is not a single medical document testifying to [any damage from fluoride]. It is clear that if there were even just a small hint of harm, US fluoridation of drinking water would be halted.”
On Monday, US Surgeon-General Regina Benjamin – the highest medical authority in America – officially endorsed community water fluoridation.
“It is one of the most effective choices communities can make to prevent health problems while actually improving the oral health of their citizens. Fluoridation’s effectiveness in preventing tooth decay is not limited to children, but extends throughout life, resulting in fewer and less severe cavities,” Benjamin wrote. “In fact, each generation born since the implementation of water fluoridation has enjoyed better dental health than the generation that preceded it.”
Every surgeon-general for the past 50 years has endorsed fluoridation of community water supplies as a safe and effective weapon in the war against tooth decay. The American Dental Association has supported fluoridation since 1950.
“The ADA’s policies regarding community water fluoridation are based on the best available science showing that fluoridation is a safe, effective way to prevent dental decay,” ADA president Dr. Robert A. Faiella said.
“The ADA, along with state and local dental societies, continues to work with federal, state and local agencies to increase the number of communities benefiting from this very effective public health measure.”
“We applaud Dr. Benjamin for making this public endorsement of fluoridation,” Faiella said.
An authoritative source in the British Medical Journal, asked to explain why Britain does not require fluoridation, told The Jerusalem Post that “most sensible, intelligent, well-informed people here in the UK think fluoridation of the water is a very sensible idea but a very vocal minority of cranks have campaigned against it for so long and so vociferously that all attempts to introduce it here [except in the west Midlands] have come to nothing. Dentists say it is a bit less important now that fluoride has been added to toothpaste, but obviously some poor kids in very deprived homes don’t brush their teeth.”