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To fluoridate or not to fluoridate

By Anne Matthews-Frederick - posted Thursday, 23 October 2008

Decades after the rest of Australian capital cities, Brisbane is to add fluoride to the city’s fluoride-free public water supply. Prior to 2007, only local government which controlled each local area water supply could make this decision after direct consultation with its community. A fluoridated water community could co-exist beside a non fluoridated community.

During compulsory amalgamation of the regional councils during 2007, the state government transferred control of water to the state. One of the reasons for this is seen in the immediate decision to fluoridate the state’s water supply. It will also make it easy to transfer or sell the people’s water supply in the future.

Mandatory fluoridation has been supported by political parties in an ad hoc fashion until the majority of state politicians united in 2008 to pass the bill to allow fluoride to be added to water that was once described as one of the “safest” and cheapest tap waters in the world.


Instead of spending a dollar or more to drink bottled water, anyone of any economic status could drink “safe” public or private tap water at a cost of a cent or two. All this has changed. Without a mandate, politicians acting as though they have majority support and believing they act in the best interests of the community have rushed through a decision that could have been the next election issue. In political time, an 18-month delay is miniscule, and government could have received a clear mandate: to fluoridate or not to fluoride.

Queensland State Premiers have had different positions on mandatory fluoridation; in 2005 Premier Beattie was anti fluoridation; in 2007 Premier Bligh was pro fluoridation. During the term of Lord Mayor Soorley, in 1997 the Brisbane City Council established a task force to consider the fluoridation issue. After six months the 17-person panel representing all sections of the community, including the Australian Dental Association (ADA) and Australian Medical Association (AMA), reached the conclusion it “would not support the introduction of water fluoridation until the recommended Australian research has been carried out” as it found a credible or non ambiguous collection of data and research did not exist.

The taskforce also expressed concern about the lack of scientific research on the lifetime effects of an accumulation of fluoride in the body, noting this is unaddressed in 1997 despite a statement in the 1991 National Health and Medical Research Council (NHMRC) Working Group report that “it was imperative that public health recommendations in the future be based on accurate knowledge of the total fluoride intake of Australians (NHMRC 1991, Section 8.3)”. This statement is repeated in the NHMRC report 1999 (p 183).

Perhaps lack of reliable studies accounts for Queensland Health (QH) stating as fact, on its page “common fluoride myths” (PDF 163KB) that global studies reveal no evidence of any link between water fluoridation and cancer/allergies/arthritis/bone fractures/health risks for babies and excessive dental fluorosis.

Total fluoride intake is the issue. Natural fluoride occurs in some foods and waters. In some parts of the world naturally occurring fluoride presents a serious health risk to the population. QH says the World Health Organization (WHO) endorses fluoridated water: however, the WHO also warns “fluorosis remains a problem in areas (of) where the natural concentrations of fluoride is high”.

Fluoride is present in foods and drinks when these are manufactured in areas where natural or non natural fluorides are in the water supply. Queenslanders already drink fluoride. It is in beer, wine, bottled water, even tea leaves. From December 2008, it will be in the tap water too.


QH recommends the maximum daily dose of fluoride be 0.8ppm. For a 50kg adult, this equates to approximately 1.2 litres of tap water or five glasses of fluoridated liquid. The 1999 NHMRC report adds that cooking with FW adds 0.5mg/l to a product that already includes fluoride, for example pasta, vegetables, soup, fish, chicken, baby food, infant formula. A fact QH states is “fluoridated water can be safely used to reconstitute infant formula, and the risk of dental fluorosis is low”. This assumes the level is at 0.15ppm and baby has no other fluoride source through juices, tinned food, dessert, soft drink, cordial. (NHMRC 1999). As dietary consumption of fluoride is non discretionary, an overdose is unavoidable and the real dose ingested cannot be measured or monitored.

As mandatory fluoridation of a nation’s food chain eliminates real choice on ingestion, control over non discretionary sources to prevent over dosing is the only avenue available. This is an area in which health professionals take the most interest and for good reason according to the 1999 NHMRC report p182 which states “The public perception of fluoridation as a health benefit may be endangered if the prevalence of fluorosis continues to increase at its current rates”. As fluorosis is the sign, or canary in the tunnel, that the population is consuming too much fluoride the concern is appreciated.

On page 189 the report further states the increase in more severe cases of fluorosis “has social and economic costs which need to be weighed against the marginal reduction in caries experience”. The report also expresses concern that children with mild degrees of fluorosis (TSIF Index ranges from 0-7) can be affected psychologically and the trend towards fluorosis increasing is “undesirable as it places dental professionals at increased risk of litigation”.

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About the Author

Anne Matthews-Frederick spent seven years in the teaching profession, followed by a 1980s "sabbatical" on a Sunshine Coast hinterland acreage at Carter's Ridge. In 1988 the family returned to Brisbane where Anne embarked on a successful career as a real estate agent. During this period, Anne created her own newsletter Life@Windsor-Wilston-Grange and website.

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