Tuesday, 13th March 2007

IRISH EXPERT BODY ON FLUORIDES AND HEALTH 
STATEMENT ON WATER FLUORIDATION

The Irish Expert Body on Fluorides and Health today stated that there is overwhelming scientific evidence to support the safety and efficacy of water fluoridation in Ireland.  It also stated that there is no scientific evidence worldwide to suggest that it causes any ill medical effects.  Oral health surveys since the 1960’s have clearly demonstrated the benefits of Ireland’s policy of water fluoridation with a significant reduction in dental decay evident across all sectors of Irish society. To date, there has been a highly significant reduction in decayed, missing and filled teeth (dmft) in Ireland for children living in areas supplied by fluoridated drinking water compared to non-fluoridated areas. It states that there continues to be robust evidence that water fluoridation significantly benefits dental health and is an important counterbalance to poor oral health practices and higher levels of snacking on sugary foods and drinks amongst Irish teenagers. 

The Expert Body emphasised that there is no health risk to any member of society including babies from consumption of fluoride in breast milk, infant formula, water or foods at the levels of fluoride observed in Ireland. It expressed concern on the confusion regarding potential health risks associated with the use of fluoridated water to reconstitute baby formula and states these concerns are unfounded. Advice to parents remains unchanged. The use of fluoridated tap water in Ireland to make up baby formula is considered safe. Based on the conclusion of a Food Safety Authority of Ireland risk assessment published in 2002, the Expert Body accepts that the risk of moderate dental fluorosis of the permanent dentition is very low in formula-fed infants aged 0-4 months residing in areas where fluoride levels do not exceed the statutory limit.  

It is inadvisable for people to switch from using tap water to bottled water to make up infant formula. Bottled water is generally not advised for use other than in exceptional circumstances such as where home water is unfit to drink.. In such situations, the advice of a public health nurse or paediatrician should be sought as to suitable bottled waters available at the time. Many bottled waters are unsuitable for reconstituting infant formula due to high concentrations of sodium and other ions which may be harmful to an infant over prolonged periods of usage.

According to Dr Seamus O’Hickey, Chairman of the Expert Body, water fluoridation is one of the most widely studied public policy initiatives in the world with approximately 350 million people in some 60 countries globally residing in areas served by optimally fluoridated water supplies.  He added that the World Health Organization only last month renewed its call for Governments throughout the world to consider using water fluoridation as an efficient public health measure.  

“Statements which are being put in the public domain that are not founded on proper science could cause concern amongst consumers. There is no scientific evidence that water fluoridation causes any ill medical effects. There are no known significant side effects of water fluoridation other than dental fluorosis, and this has been known for some 60 years. In the absence of water fluoridation, we could expect to see the average 5-year old child in the Republic of Ireland having 4-5 more decayed, missing or filled teeth.” 

“Dental fluorosis is not a disease; it is a cosmetic condition which refers to the way teeth look. Given the levels at which fluoride is present in Ireland’s water supply, any incidence of dental fluorosis is likely to be mild and in most cases only detectable by a dental practitioner as faint white 
flecks on the surface of teeth,” Dr O’Hickey stated.

The Expert Body highlighted the benefits of water fluoridation stating that, in the early 1960’s the mean rates of dmft in 5-year-old children in Ireland was 5.6 in the Republic and 4.8 in Northern Ireland.  Following the introduction of fluoridation in the Republic, subsequent surveys reported mean dmft rates of 1.8 in 5-year-olds living in fluoridated areas in the Republic in 1984 in contrast to the average DMFT rate of 4.5 in 5-year-olds living in non-fluoridated areas in Northern Ireland in the same period.

The Expert Body is aware of an interim guidance statement from the American Dental Association in relation to the use of tap water to reconstitute powdered infant formula.  In the US, drinking water may contain fluoride at up to 4.0 parts per million (ppm) compared with up to 1.0ppm in Ireland. This results in the possibility of infants receiving a larger than optimal amount of fluoride through infant formula prepared using drinking water in the US.  As 1.0 ppm is the current limit* for artificially fluoridated tap water in Ireland, the Expert Body continues to advise that infant formula should be reconstituted with boiled tap water. The Expert Body considers that fluoride concentrations in Irish tap water pose no known medical problems for infants or the population in general. 

The Expert Body’s view is that fluoridation continues to be a crucial and beneficial healthcare policy in Ireland.  

* http://www.dohc.ie/legislation/statutory_instruments/pdf/si20070042.pdf?direct=1 

ENDS

FOR INFORMATION: 
Siobhan Molloy, Weber Shandwick 	Tel: (01) 6760168

Or

Secretariat, Irish Expert Body on Fluorides and Health	Tel: (01) 478 0466

NOTE:

About the Irish Expert Body on Fluorides and Health 
The Minister for Health and Children, Micheál Martin TD established the Irish Expert Body on Fluorides and Health in April 2004. It has broad representation from the areas of dentistry, public health medicine, engineering, management, environment and the public, as identified within the Report of the Forum on Fluoridation, (2002). It has a strong consumer input in terms of members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs. The Expert Body provides an advisory role to the Minister for Health and Children, and continues to monitor worldwide research on fluoridation. 
 
The effectiveness of water fluoridation in preventing dental decay is endorsed by a comprehensive range of international bodies including: 
o	the World Health Organization
o	the Centres for Disease Control and Prevention, Atlanta, Georgia, USA.
o	the US Public Health Service  
o	the US Surgeon General
o	the FDI World Dental Federation, 
o	the International Association for Dental Research