|12 August 2013
Mr Barry Harris
Hamilton City Council
Private Bag 3010
Dear Mr Harris,
I am writing with regard to the fluoride information leaflet that has been circulated with the rates invoices to Hamilton City residents over the last month.
The reason for not writing sooner is that we were under the impression that circulation had already occurred; however discovered this week that the distribution has been batched.
Waikato District Health Board is concerned that the information provided does not represent Ministry of Health advice. Specifically, we do not support the bolded words below.
1. "Fluoride toothpaste provides topical application. The Ministry of Health recommends a pea sized amount be used.
Lower strength toothpaste is also available and marketed specifically for children (children should be discouraged from swallowing or eating the toothpaste).
2. Application by toothpaste or other means that directly affect the tooth surface are much more effective at reducing tooth decay than fluoridation of water supplies.”
We disagree with these statements, on the grounds that:
The Ministry of Health recommends that 1000 ppm (adult toothpaste) be used, based on the consensus of many years of research on the effectiveness of different strength toothpastes.
However, a smaller amount of adult toothpaste (just a smear of toothpaste on a small brush) should be used for younger children. Children should also be discouraged from swallowing or eating toothpaste.
The most widely known and used topical fluorides are incorporated into toothpastes. In many countries, over 90 per cent of the toothpastes marketed, contain fluoride as sodium monofluorophosphate, sodium fluoride, stannous fluoride or amine fluoride.
Fluoride toothpaste is an effective method of reducing dental caries. It provides an additional benefit above that of fluoridated water. In non-fluoridated areas it is the prime method of preventing decay (Murray et al 1991).
Some risk of fluorosis is associated with using both fluoride toothpaste and fluoridated water during the tooth forming years because of young children swallowing toothpaste.
Most fluoridated toothpastes on sale in New Zealand contain 1000ppm of fluoride. A 400ppm fluoride toothpaste is available for use by children under six years.
The Ministry of Health has not advised that application by toothpaste or other means that directly affect the tooth surface are much more effective at reducing tooth decay than fluoridation of water supplies. It advises that application by toothpaste provides an additional benefit above that of fluoridated water.
This statement implies that community water fluoridation does not work topically, which is incorrect. Waikato DHB has never promoted community water fluoridation based on systemic effects. It has always been the low dose topical rinsing of the teeth with fluoridated water that has been promoted.
This statement is directly associated with misinformation spread by those opposed to community water fluoridation. Hence, we believe this pamphlet is not neutral.
We also note that Hamilton City News has used the second statement in its publication.
As a public body, Hamilton City Council has a responsibility to provide accurate and non-misleading information.
On this basis, Waikato DHB requests that:
Hamilton City Council refrain from distributing any more of these leaflets.
The information is removed from the Hamilton City Council website.
This information is corrected and this correction is distributed in writing to every ratepayer in the same form (leaflet) or that a correction is made in an edition of the City News prior to 12 October 2013.
The information the city council is putting in the voting papers around the history of fluoride includes the fact that there was a referendum in 2006 at which 70 per cent of the voters wanted fluoride to remain in the tap water.
Information prepared for the referendum voting papers is sent to Waikato DHB for review prior to publication.
Dr Anita Bell
Medical Officer of Health