Fluoridation of Public Water: The Elephant in the Room?

A report suggests fluoride should be added to more drinking water supplies in England. Unfortunately not everyone agrees.

There's an elephant in the room. Not, literally, of course. That would be odd and animal rights campaigners would no doubt be after me. The theoretical elephant I talk about is fluoride. That's utilities adding fluoride to drinking water supplies. It seems this topic is as controversial in the water industry as that of tariffs!

A report from Public Health England (PHE) launched back in March said dental health could be improved across England if fluoride is added to more water supplies. They specify that the level of fluoride should be adjusted to 1 mg per litre (1 part per million). The maximum amount permitted in drinking water is 1.5 mg/ litre.

Although fluoridation has been more popular in countries such as Australia and the US, England is one of the few European countries that adds fluoride to water.Historically, it was in the early 20th century when lower levels of tooth decay were found to be associated with certain fluoride levels in drinking water. In the US, the first scheme was introduced in 1945 in the city of Grand Rapids, Michigan. Nearly 20 years later in the UK fluoridation was introduced to the city of Birmingham in 1964. Today, over 200 million US citizens drink water with the fluoride level adjusted. This compares to six million in England.

In its report, PHE said 28% fewer five year olds have tooth decay in fluoridated areas than non-fluoridated areas. This is with deprivation and ethnicity taken into account.

Yet campaigners and controversy have been rife since fluoridation started. US campaign group - Fluoride Action Network - says this process is "unethical", claiming fluoride is classified as a drug and there should be "informed consent" from people taking it in water supplies.

One respondent in a WWi LinkedIn Group debate articulated his anger: "Public Drinking Water Systems are not pharmacies and water treatment operators are not pharmacists…How about some lithium in our more violent neighbourhoods, some birth control in poor neighbourhoods or some Viagra in the senior citizen complex?"

PHE addressed health concerns in the report, saying that "there is no evidence of harm to health in fluoridated areas".

Major utility Severn Trent Water said it could not comment on fluoridation as it takes instruction from the "Strategic Health Authorities" on this matter. Thames Water echoed the response – saying it's not a matter for them to comment on as it's mandated by the local Strategic Health Authorities.

Utilities perhaps washing their hands of the issue? To their defence, it was on 1st April 2013 when the responsibility for existing fluoridation schemes switched to the Secretary of State for Health in the UK.

Clearly this elephant in the room won't be leaving anytime soon.