Sir, - I agree with John Colgan's conclusion (July 19th), that mass water fluoridation is contrary to consumer choice. He also questions the ethics of forcing a population to ingest a medicine (fluoride) against their will.
The ethics of this mass medication, via the water supply, will be further challenged when Ireland signs up to the Council of Europe's Convention on Human Rights and Biomedicine (1997). Article 5 of the convention states, "Intervention in the heath field may only be carried out after the person concerned has given free and informed consent to it. This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks. The person concerned may freely withdraw at any time."
The Government has never requested the free informed consent of the population to give them fluoride in their water supply. As informed consent also requires the knowledge of both risks and benefits, the Department of Health has failed to educate the Irish public that fluoridation contributes to dental fluorosis.
Dental fluorosis is tooth damage caused by ingesting or swallowing fluoride and is seen as white lines, white spots or, in more severe cases, as pitting and brown staining. As a dentist, I see patients with this fluoride damage on a daily basis and in my dental surgery it now affects between 40- 50 per cent of all children and teenagers.
The Department of Health admits that, "fluorosis levels are a bio-marker of fluoride in the body". Therefore, it is essential to review our total fluoride intake.
Back in the 1960s, when fluoridation was introduced in Ireland, there was no fluoride toothpaste, fluoride mouthrinses or fluoride tablets. In addition, all Irish products made with tap water (e.g. beverages, processed food and beer are in effect "fluoridated"). Nowadays, we are swallowing more fluoride than ever before.
In this environment, scientific thought, on the beneficial action of fluoride has also changed since the 1960s. Now dentists believe that the benefits of fluoride in reducing tooth decay are topical (i.e. fluoride in saliva in contact with the tooth via toothpaste).
This topical action undermines the original theory of systemic (swallowed) fluorides previously accepted when Ireland initiated mandatory water fluoridation.
In conclusion, it would seem logical that if the benefits are topical and the risks are systemic then why continue water fluoridation, which produces the least benefit with the greatest risk of damage. This is yet another sound, scientific reason for the immediate cessation of water fluoridation. - Yours, etc.,
Dr Don MacAuley, Dental Surgeon, Church Hill, Navan, Co Meath.