Most countries have rejected fluoridating their drinking water. South Africa is an exception to the rule as water boards and other suppliers are forced by government to fluoridate our drinking water. Some see this as being unconstitutional and harmful to our health and are fiercely debating the issue.

What is it all about?

Fluoridation of water supplies has always been a highly controversial and emotional issue hotly debated by pro- and anti-fluoridation lobbies worldwide. The pro-fluoridation lobby consists mostly of the dental fraternity and some government officials as well as suppliers of fluoride while the anti-fluoridation lobby consists mostly of concerned, informed consumers as well as environmentalists and some members of the medical and dental fraternity.

What’s so special about fluoride?

Fluoride is an essential trace element needed for the development of healthy, caries-free teeth. According to the World Health Organisation (WHO), fluoride is acquired through the diet and is also present in both surface and groundwater and in the air (mostly from production of phosphate fertilisers or burning of fluoride-containing fuels). This means that the amount of fluoride people actually ingest may be higher than assumed. It is also a commonly used industrial chemical and highly toxic in concentrated form.

Pros and cons of adding fluoride to drinking water

Pro-fluoridation proponents point out that lack of access to oral health care is a pressing issue for a large segment of South Africa and other developing nations’ populations. Adding fluoride to drinking water will help prevent tooth decay.

Anti-fluoridation proponent and dentist, John Colquhoun, points out that new evidence strongly indicates that water fluoridation today is of little if any value “because the main action of fluoride on teeth is a topical one (at the surface of the teeth) and not a systemic one as previously thought, so that there is negligible benefit from swallowing fluoride”.

Other anti-fluoridation proponents point out the following possibly, harmful effects of too much fluoride in the body:

    • Dental fluorosis. This is a disturbance in the formation of tooth enamel causing unsightly, discoloured, mottled and in severe cases pitted teeth. Parents worldwide were warned to drastically reduce the amount of fluoride toothpaste used by their children and to caution them not swallow any.
    • Weakened bones. A substance such as fluoride may also be able to damage bones, as recent studies have proven. Finland actually stopped fluoridation of its water after discovering that people, especially osteoporosis sufferers and people with impaired kidney function, had accumulated extremely high levels of fluoride in their bones. Polish researchers reported that boys with dental fluorosis also exhibited bone structure disturbances.
    • Bone cancer. Osteosarcoma (a rare bone cancer) rates of young males living in certain fluoridated areas of America were found to be three to seven times higher than in non-fluoridated areas.
    • Brain damage. Studies have shown that fluoride can also accumulate in certain areas of the brain that may affect intelligence, learning and behaviour in children.
    • Other diseases implicated by the anti-fluoridation groups include depressed thyroid activity, kidney damage and interference with the immune system.

South African scenario

In September 2001, the SA government legislated regulations indicating that water service providers were obliged to fluoridate water as of September 2002.

Many individuals and environmentalists objected. Water boards and other suppliers, Rand Water in particular, made several submissions to the appropriate ministries seeking “indemnity from the Department of Health against any claims arising from the fluoridation of water that may give rise to possible health implications or impact on the environment or industrial water users”.

South Africa has 803 endemic fluorosis areas. Dental fluorosis in both children and adults is clearly manifested in some of these areas and cases of severe skeletal fluorosis in adults have also been reported.

Rand Water also questioned the cost effectiveness of this method of augmenting the dietary fluoride intake of rural South Africans and suggested that the total estimated national cost of R30 million per annum should rather be used to extend the provision of free water to these people. They were also concerned about monitoring the fluoride levels in water bodies and the costs of de-fluoridation should they rise above the recommended “healthy” levels.

Future initiatives

Despite all these warnings, questions and queries, the government has not responded and the fluoridation of our drinking water continues unabated.

Maybe UNICEF is right when it remarks that “some governments are not yet fully aware of the fluoride problem or convinced of its adverse impact on their populations. Efforts are therefore needed to support more research on the subject and promote systematic policy responses by governments.”

 

Sources
Colquhoun, J. Why I changed my mind about water fluoridation. Retrieved from: http://www.fluoridation.com
Fawell, J. etal. Fluoride in drinking-water. Retrieved from: http://www.who.int
Fluoridation of tap water. Retrieved from: http://www.randwater.co.za
UNICEF’s position on water fluoridation. Retrieved from: http://www.nofluoride.com