Fluoride Could Negate Sugar Problem; Recent Calls Have Been Made by Medics for the Welsh Government to Fluoridate Water Supplies as a Means to Improving the Dental Health of the Nation. the Welsh Government Has Said It Will Keep the Matter under Review. Here, Dental Hygienist Alison Lowe Looks at the Impact of the Mineral on Our Teeth
Byline: Alison Lowe
READERS may be aware of the recent controversy surrounding the great fluoride debate. I guess if teeth aren't your thing you could be excused for wondering what all the fuss is about but fluoridation of water supplies is a cost effective, safe intervention that has been proven to reduce levels of decay by approximately 50%. Indeed, water fluoridation has been described as one of the 10 most important public health advances of the 20th century. Therefore the Welsh Government's reluctance to fluoridate water supplies has sparked quite a debate among those in the know.
Almost half of children under the age of five in Wales are suffering from tooth decay. The principal cause of decay is the frequent consumption of sugar, mainly found in sweets and fizzy drinks. Bacteria in the mouth rapidly convert this sugar into acid and over time the build-up of acid attacks the tooth surface causing a cavity. Of course, it doesn't help that so many foods in the UK have such a high content of sugar. Indeed, cereals here have up to 30% more sugar than their equivalent versions in the US. Nonetheless, while diet advice is important, there is no doubt that the provision of fluoride would bring about a huge reduction in the levels of dental decay among children in Wales.
So, what is fluoride? Well, fluorides are compounds of the chemical element fluorine. They are widely found in nature, in some foods such as fish (bones), in tea and beer. Fluoride can occur naturally in the water supply, for example the water supply of Hartlepool has a natural fluoride content of 1.2 parts per million (PPM). All water contains fluoride to some extent because of the natural minerals present. Read the label on any bottle of shop bought mineral water and you'll see a long list of minerals including fluoride in the typical analysis.
And now for a potted history. The link between the presence of fluoride in public water supplies and a reduction in dental decay was first noticed early last century when researchers discovered that people living in areas where water contained naturally high levels of fluoride suffered less tooth decay than those living in other areas. Further studies found that a measure of one part per million (1ppm) was optimal for a significant reduction in dental caries.
Researchers reached the conclusion that the benefits of naturally occurring fluoride could be replicated in areas where the level of natural fluoride was low, by artificially increasing the measure to an optimal level of 1ppm. In case you're wondering, the concentration of fluoride in water is measured with a fluoride ion specific electrode.
In 1944, the US Public Health Service employed a dentist, Dr Trendley Dean, to test this theory on a community living in the Grand Rapids. He found that mottling of the teeth, known as the Colorado stain, was extremely rare at fluoride levels of 1ppm or below and that this was also the optimum level for the caries preventive effect. Similar results were found in studies carried out in Canada, East Germany and New Zealand. With this in mind, in 1953 the UK Government arranged for a medical health expert to visit the North American trial sites used by Dr Trendley Dean and as a result fluoridation schemes were established in Anglesey, Watford, Kilmarnock and Andover.
The pilot schemes were closely monitored with reports published at five and 11 year intervals. Not surprisingly, levels of decay dropped significantly in this time. The authorities in Birmingham, Solihull and Newcastle introduced fluoride to their water supplies in the following years and by the early 1980s approximately 10% of the UK population had access to fluoridated water. Today approximately six million people in the UK receive water with the fluoride level adjusted to the optimum level. The West Midlands is the most extensively fluoridated area followed by parts of the north west of England. …