Monday, November 10, 2003
Rather late in the day to discover this, but as the debate about plans for compulsory flouridation heats up, I have discoovered the "York Committee" report from the Centre for Reviews and Dissemination (CRD) The Department of Health commissioned CRD to conduct a systematic review into the efficacy and safety of the fluoridation of drinking water; its review was published in October 2000. The Centre now writes at http://www.york.ac.uk/inst/crd/fluoridnew.htm that "We are concerned about the continuing misinterpretations of the evidence and think it is important that decision makers are aware of what the review really found. As such, we urge interested parties to read the review conclusions in full at http://www.york.ac.uk/inst/crd/summary.pdf."
What I found startling was the headline conclusion:
"We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.
What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.
This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.
An association with water fluoride and other adverse effects such as cancer, bone fracture and Down's syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.
The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.
Since the report was published in October 2000 there has been no other scientifically defensible review that would alter the findings of the York review."
The full report is available via the CRD Fluoridation Review web site (http://www.york.ac.uk/inst/crd/fluorid.htm).
(Now, speaking personally, I have long been very dubious about fluoridation on the grounds that it is liable to induce changes in bone composition just as much as teeth, and this so more than well-flushed toothbrushing. I can recall various reviews, eg one in Science and Public Policy in the '90s, that gristed this mill. What I didn't realise is that the opponents' claim about the tenuousness of te pro case was perhaps better-founded!)
What I found startling was the headline conclusion:
"We were unable to discover any reliable good-quality evidence in the fluoridation literature world-wide.
What evidence we found suggested that water fluoridation was likely to have a beneficial effect, but that the range could be anywhere from a substantial benefit to a slight disbenefit to children's teeth.
This beneficial effect comes at the expense of an increase in the prevalence of fluorosis (mottled teeth). The quality of this evidence was poor.
An association with water fluoride and other adverse effects such as cancer, bone fracture and Down's syndrome was not found. However, we felt that not enough was known because the quality of the evidence was poor.
The evidence about reducing inequalities in dental health was of poor quality, contradictory and unreliable.
Since the report was published in October 2000 there has been no other scientifically defensible review that would alter the findings of the York review."
The full report is available via the CRD Fluoridation Review web site (http://www.york.ac.uk/inst/crd/fluorid.htm).
(Now, speaking personally, I have long been very dubious about fluoridation on the grounds that it is liable to induce changes in bone composition just as much as teeth, and this so more than well-flushed toothbrushing. I can recall various reviews, eg one in Science and Public Policy in the '90s, that gristed this mill. What I didn't realise is that the opponents' claim about the tenuousness of te pro case was perhaps better-founded!)
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