Published on January 3, 2012

Another barrier to fluoridation: cost

The addition of fluoride to public water supplies is an emotive and controversial topic, and has been so for a long time. In the film Dr Strangelove, General Ripper obsesses over the damage fluoridation could do to ‘precious bodily fluids’, indicating that the debate was well-known enough to parody even in 1964. The 1950s flyer below – sadly not a parody – portrays fluoridation as an attempt by communist infiltrators to weaken America.

Few now believe that fluoridation is a Soviet plot, but the practice still has vehement opponents just as it does ardent supporters.

In his Bad Science column in 2008, Ben Goldacre stated that the evidence was poor on both sides of the argument – that studies on both the benefits and potential harms of fluoridated water were of insufficient quality to make a decision one way or another. Today’s widespread use of fluoride toothpaste and accompanying decrease in caries prevalence makes assessing the impact of fluoridation difficult – and might, indeed, make it unnecessary even if it did confer a theoretical benefit.

One argument in favour is that fluoridation might iron out inequalities in dental health – caries rates remain higher in lower socioeconomic groups, and those with inadequate oral hygiene would benefit the most. Many, though, are opposed on principle to what they consider to be the involuntary medication of the general public.

Regardless of the scientific support for fluoridation, a more prosaic problem may yet present itself should fluoridation go ahead on a wider scale in the UK. The proposed Health and Social Care Bill will give local authorities responsibility for fluoridation consultations. In recent debate in the House of Lords it was pointed out that, since local councils don’t bear the cost of dental treatment, there may be little financial incentive for them to carry out costly fluoridation programmes – couple this with a sceptical public and the whole project might well lose its appeal.

While on the topic of adding things to public supplies, did you know that adding iodine to salt may have raised the world’s IQ? The United States and Kazakhstan are both countries which have countered a shortage of dietary iodine with fortified salt – a cheap, simple and effective measure which prevents mental retardation and goitre.

Unsurprisingly, this has also ignited fury amongst sceptics.

More information on the ‘unholy three’ flyer here:

on fluoridation’s cost here:–Oral-health-Cost-may-quash-fluoride-plans

and on the remarkable success of salt iodisation in Kazakhstan here:

Ben Goldacre’s article on the evidence base for fluoridation, and General Rippers’ opinions, can be found at his Bad Science blog:

Happy New Year!

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