The interminable fluoridation debate – is it time to call a halt?
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Published On:17-03-2014 by Dr John Renshaw

An article in a recent British Dental Journal revisits the issue of fluoride intake of children. The article points out that very young children are particularly and positively affected by the availability of fluoridated drinking water, that diet is the only source of fluoride for most infants and the importance of dietary evaluation prior to recommending the use of additional fluoride supplements Zohoori, F.V., Whaley, G., Moynihan P.J. and Maguire A. BDJ, 216, E3 (2014).


The scientific validity of claims for the effectiveness of drinking water fluoridation are generally questioned only by those whose position is radically anti-fluoride, whether their opposition is claimed to be based on the science or the ethics. For decades the benefits of water fluoridation have been set out in research paper after research paper, politicians have been battered by propaganda and Local Authorities have been begged to adopt local fluoridation schemes for the good of the oral health of the children who live in their areas.


And little or nothing has actually been achieved. Southampton is the latest city to attempt to fluoridate the water supply serving the poorest areas of the city and they have run into the same objections and legal blockades.
Is it not time to accept that, notwithstanding the validity of the scientific argument supporting water supply fluoridation, the idea of medicating the water supply is a step too far for the vast majority of the people of this country? What might have been possible when mass medication was believed to be the way to improve general public health is now seen as politically unacceptable and a definite vote loser for whatever political party puts it forward.


The days of mass medication are surely over. People nowadays know how to look after themselves and have no wish to have additional chemicals added to their drinking water. They see this as an unwarranted and highly personal interference in their lives without public support and without a real chance for the people to object. Councillors and MPs listen to their constituents listen to the views they express loudly and sincerely and then vote accordingly. The result is exactly what we have seen since Birmingham’s water supply was successfully fluoridated in 1964. Little or no further water fluoridation progress has been made.


This is not a rant against water fluoridation so much as a plea to listen to, recognise and understand the strength of the public opposition and to realise it is highly unlikely we will ever see mass fluoridation of the water supply and perhaps that might not be so bad.


Oral health is improving generally and the minority of children who need the help we could offer via the water supply are not likely to ever receive it. That may seem harsh and unkind but if the mass of the people have implicitly or explicitly decided that water supply fluoridation is not to their taste we are wasting precious time and resources on a project that is doomed to repeated failure.


Would it not make more sense to accept the ‘realpolitik’ we face and spend our time and energy pursuing a different approach that might have a greater degree of acceptability and effectiveness?



John Renshaw has been a general dental practitioner for 44 years and still works four days a week in private practice in Scarborough. He specialises in dental practice management, primary care dental service commissioning issues, legal compliance within the practice, complaints resolution and wider healthcare policy.


John was chairman of the BDA between 2000 and 2006, and has held senior representative roles with the NHS and the Department of Health. He was Dental Practice Adviser to various primary care organisations over a period of 15 years and is still Secretary to the Yorkshire Branch Council of the BDA.


  1. Although I appreciate that Dr Renshaw is laying down the olive branch, I am puzzled that he still believes that fluoride has a part to play in modern medicine. Having read widely on the topic, I am absolutely convinced that fluoride is a dangerous substance. In a recent systematic research report, Grandjean and Landrigan have classified fluoride as being a developmental neurotoxicant. This is in line with the EPA’s classification of fluoride as a “chemical with a significant evidence of developmental neurotoxicity” Masters and Coplan found that fluoride increases the uptake of lead (and lead causes dental decay). Universities the world over have demonstrated that fluoride interferes with the Electron Transfer Chain in the mitochondria with a consequent reduction in ATP cell energy. Jennifer Luke demonstrated that fluoride reduces the production of melatonin and has a role to play in early puberty. Faccini described the process of fluoride replacing the hydroxyl radical in the apatite lattice of bone meaning that all artificially fluoridated individuals are altered humans. Another adverse affect is that fluoride prevents the normal activity of cholinesterase. Finally numerous studies have demonstrated that fluoride reduces intelligence. Need I go on? Fluoride is NOT safe and effective. It may not kill us outright in small concentrations but it causes sub-clinical symptoms which become obvious when the body becomes low in essential minerals and vitamins or when there is another disease present. This is a heavy price to pay for the sake of protecting relatively few milk teeth belonging to disadvantaged children. Ethically, water fluoridation is anathema and fast becoming as outdated as radium pills and lobotomy: both were also whacky 20th Century ‘medical’ fads.

    Joy Warren, BSc. (Hons) Environmental Science
    Coordinator, West Midlands Against Fluoridation

  2. The long running argument over the medical efficacy of water fluoridation in the battle against tooth decay will never be won by either side. One side tells us the argument is so clear and decisive it is not even worth discussing. The other side tells us this is garbage and the opposition are merely trying to poison the whole population in pursuit of a small improvement in child dental health.

    What I was trying to say in my article was that the violence of the scientific argument has destroyed any credibility for water fluoridation among the population – whether it works or not.

    In view of this scientific stand-off it seems to me high time that the more important ethical argument is given greater discussion time. The fluoridation argument has diminished in power since oral health in general has improved and any use of huge schemes to fluoridate water supplies are doomed to failure for lack of popular support, high cost and lack of political will.

    I did not want to go over the sterile scientific debate yet again and be subjected to yet another tirade of slanted research material. To be brutally honest, I don’t really believe either side or their analysis of the evidence.

    Fluoridation of the water supply – it seems to me – is a throwback to an era of grandiose public health gestures that would not be supported in the 21st century by a population that has been given ample reason why they should not trust the scientific community to get these things right.

    In the absence of irrefutable proof of a proposal’s total safety the best plan is to decide NOT to adopt the idea. The science is hopelessly muddled on both sides of this particular fence.

    Can’t we just close this argument down once and for all and move on to something that might do some real good and might even have a chance of being implemented?

    John Renshaw

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