POSITION PAPER ON WATER FLUORIDATION The Irish Dental Association (IDA) strongly endorses water fluoridation as the most practical, cost effective and safe, public health measure to control the occurrence of tooth decay in Ireland. Community water fluoridation is endorsed by the World Health Organisation (WHO) as the first choice method of providing fluoride to communities. The US Centers for Disease Control and Prevention (CDC), and the EU Scientific Committee on Health and Environment Risks (SCHER) have also endorsed water fluoridation. The US Surgeon General described water fluoridation as one of the top ten greatest public health measures of the twentieth century.
Fluoride is a natural component in water in many places across the world. Community water fluoridation was introduced in Ireland in 1964. Since then, there has been a dramatic reduction in the prevalence of tooth decay. In spite of the advent of other products containing fluoride, this reduction is still greater in areas with water fluoridation. Fluoride benefits individuals throughout their lifetime and has been shown to reduce oral health inequalities between different socioeconomic groups.
The Irish Dental Association endorses the evidence that suggests that water fluoridation, along with reduction in the frequency of intake of sugary foods and drinks, as well as tooth brushing with a fluoride containing toothpaste are the key approaches to reducing tooth decay for the people of Ireland. However, Ireland still needs the protection of water fluoridation as the Health Behaviour of School Aged Children surveys have shown that Irish children have very high levels of consumption of sugary foods and drinks as well as poor tooth brushing habits.
The Irish Dental Association recognises that water fluoridation is a contentious issue and is regularly debated in the media. The Irish Dental Association recommends that policymakers be guided by high quality, peer-reviewed evidence.
The Irish Dental Association supports research into the risks and benefits of water fluoridation. The effects of community water fluoridation are continuously researched both in Ireland and internationally and this research is subjected to rigorous review. One such review was conducted by the Forum on Fluoridation, a body of experts established by the Minister for Health to make recommendations for Ireland. The Forum consisted of doctors, dentists, professors of dentistry, medicine, biochemistry and law, public health experts, environmentalists, engineers, economists as well as representatives from the Food Safety Authority of Ireland and the Consumer Association of Ireland. The Forum recommended the continuation of water fluoridation in Ireland at a reduced level of 0.6 to 0.8 parts per million fluoride with a target of 0.7 parts per million fluoride. This change was implemented in 2007. It is worth noting that the current maximum allowable concentration of fluoride in drinking water in the EU is 1.5 parts per million of fluoride and in the US, where there are many areas with fluoride naturally occurring in water supplies, the maximum allowable concentration is 4.0 parts per million fluoride.
The health effects of fluoride are continuously under review all around the world with no evidence of any adverse effects of community water fluoridation. Dental fluorosis in Ireland is a primarily aesthetic concern and is less difficult to treat than dental decay.
The IDA recommends that all members of the profession continue to endorse the benefits of this important public dental health measure.
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