Every so often we have to deal with the aftermath of new concerns about fluoride in drinking water. We all have our own views about this subject but, whether we are pro or anti, there is an obligation to hold the official line. However, this becomes difficult when the research is in conflict with Department of Health advice. Since an article in the Daily Telegraph this week I’m looking forward to fending off yet another attack over the next few days, from both patients in the surgery and friends who know what I do!
The report is on research published in the BMJ’s Journal of Epidemiology and Community Health which says fluoride could be causing depression and weight gain, and councils should stop adding it to the drinking water. Work from the University of Kent suggests that there is a spike in the number of cases of underactive thyroid in high fluoride areas such as the West Midlands and the North East of England. A study of 98 per cent of GP practices in England found that high rates of underactive thyroid were 30 per cent more likely in areas of the greatest fluoridation.
Conflict
Last year, Public Health England released a report saying fluoride was a ‘safe and effective’ way of improving dental health. However, lead author Professor Stephen Peckham, Centre for Health Service Studies, said: “I think it is concerning for people living in those areas.
The difference between the West Midlands, which fluoridates, and Manchester, which doesn’t was particularly striking. There were nearly double the number of cases in Manchester.”
Dr Sandra White, Director of Dental Public Health at Public Health England, said: “Public Health England regularly reviews the evidence base for water fluoridation. “The totality of evidence, accumulated over decades of research, tells us that water fluoridation is a safe and effective public health measure, and shows no association with reduced thyroid function.”
Is it research as we know it Jim?
As with all research, we need to measure it against the criteria for evidence base and depth of analysis. Other experts have warned that this study may have been skewed by population bias, a claim denied by the authors.
Professor David Coggon, Professor of Occupational and Environmental Medicine, University of Southampton, said: “It is quite possible that the observed association is a consequence of other ways in which the areas with higher fluoride differ from the rest of the country. There are substantially more rigorous epidemiological methods by which the research team could have tested their idea.”
So, when people ask, it’s OK to say, “The jury is still out!”
