NHS plan to waste money on fluoridation

Hampshire Against Fluoridation have carried out an in depth review of South Central Strategic Health Authority's financial analysis of fluoridation. This is of particular interest to me as a founder member of the Safe Water Campaign (see photo of one of our stalls in Stroud a couple of months ago) - see our blog here:
http://safewatercampaign.blogspot.com/

Our group has been seeing what can be done to help Southampton fight this latest move by their Strategic Health Authority. Below is some of what they found reviewing the financial implications - startling indeed....

The Isle of Mann have at least this last week rejected plans to fluoridate - although on the basis of a survey of 1,000 people! This is not consultation. See here.

Anyhow this is what Green party and Hampshire Against Fluoridation have found:

· Using the government's own York Review statistics and the South Central SHA's financial analysis, then the direct extra costs of fluoridation are expected to be £604,406. If the costs already committed to date are included fluoridation will cost at least £1 million pounds more to the NHS than if they do not fluoridate. This can be seen from just from the report and combining it with with the York Review that stated that the best estimate of dental improvement in five year olds is 15%.

· The analysis has a mistake in their use of statistics which means that the supposed benefits are much less. This mistake would cost the NHS another £1 million on top of the above, meaning that fluoridation, even using the SHA financial assumptions would cost at least £2 million pounds more than not fluoridating. The reduction of 15% in five year olds is not matched by a similar reduction across the population as fluoride only delays caries formation due to its effect of delaying the eruption of teeth by around one year (a serious indication of systemic fluorosis).

· The Health Authorities have excluded any consideration of the costs of treating dental fluorosis from their calculations. This is because they would force private individuals to pay for treatment. Dental fluorosis causes brown and pitted teeth which can be extremely unsightly, or worse. Assuming that only those with moderate or severe dental fluorosis would choose treatment, and taking the York Review's own figure that this would affect one in eight people in fluoridated areas, the cost of this treatment would be around £20 million pounds over twenty years. Those who are too poor to pay over £100 per treatment would have the clearly visible stigma of brown or pitted teeth, causing social scorn, loss of confidence and worse job prospects. This would be a clear stigma of poverty, the dental marks of shame. Hampshire Against Fluoridation say that these cost to put right the bad effects of fluoride must be paid for by the Health Authorities. If they continue to refuse to promise this then concerned citizens should get together and take them to court to force them to face up to the true consequences of their actions.

· There is also a complete exclusion of any side effects from fluoridation. Even the government admits that "dental fluorosis is a manifestation of systemic toxicity" (i.e. the whole body is getting gradually poisoned by fluoride). Our Health Authorities are guilty of a major misuse of science. It either means that the authors of their report have a very limited reading list or that they are wrongly excluding a mass of compelling evidence that long term ingestion of fluoride at levels of 1 ppm in water has major medical side effects. If the costs of these serious side effects are taken into consideration, even assuming some are not as bad as feared, then the extra costs to the NHS would soon come to more than £100 million, and that does not include the suffering caused to people and their loss of earnings.

John Spottiswoode, Chairperson of Hampshire Against Fluoridation and Coordinator of SW Hampshire Green Party, said: "It is clear that water fluoridation would be extremely costly to the NHS, adding millions of pounds to their costs with little, if any, medical benefit even for teeth. This is not only a waste of the NHS's scarce resources but also an absurd taking away of this money from the many health areas that so badly needed the money. It is now clear why the areas that already fluoridate their water not only have just as high costs of dentistry, but they are also pushing a lot of the costs from fluoridation onto private people to pay for. With cost figures such as these it would be clinically and financially mad to proceed with water fluoridation."

Interestingly one of the main reasons offered by 'health chiefs' in the UK for fluoridation is that it reduces health inequalities - however the conclusions of an international study are worth serious attention...In the Irish Times Health News of 10th June 2008 there was an interesting reference to an international study on health inequalities. The study which was funded by the US National Institute of Health, the Czech government, the Welsh R&D Office and a Norwegian health foundation and performed in 17 countries at 27 different sites.

Its results were published in 2004, title is "International comparisons in health inequalities in childhood dental caries." Countries looked at were: England, Scotland, Wales, N.Ireland, Ireland, Belgium, Denmark,Italy, Germany, Norway, Czech Republic, (UK members counted as one country, ie 8 countries). US & Mexico, S.Africa, Madagascar & Tanzania, China, Singapore, Thailand and Pakistan. For those who need to access it directly, here is the link;
http://www.who.int/oral_health/media/en/orh_cdh_0304_10_international.pdf

The key point for the Hampshire 'debate' is that the PCT must be pressed on this study's conclusions, which many Hampshire people have already articulated in their replies to this debate. The conclusions were : "Parental beliefs and attitudes play a key role in moderating oral health-related behaviour in young children and in determining whether they develop dental caries."

Plus: "The most significant variable for the whole study population predicting whether children would be caries-free was not the children's oral halth related behaviour but a parents' attitude to their perceived ability to deliver the behavious (in this case regular and effective toothbrushing)"(page 125) This is reinforced on page 129 by: "The results of these studies provide important new data in showing how parents' attitudes and beliefsabout oral health-related behaviour are associated with the likelihood of their children developing dental caries." As for the relevance of socio-economic factors, it went on to say: "This study also found clear variations in parental beliefs and behaviours for different ethnic and socio-economic groups that separately impact on their childrens' oral health related behaviour."

Another interesting point about this international study is that the researchers, (including long-time promoter of fluoridation in Ireland, Dr Helen Whelton from University College Cork) did not allow for the confounding factor of water fluoridation. While this omission would undermine the research validity, nevertheless the fact that fluoridation proponents downplayed its role and concentrated instead on the influence of parents getting their children to brush their teeth, is surely not insignificant.