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Wed 10 Oct 2007 04:00 AM

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Urban decay: the fluoride debate

Few things in dentistry split clinicians like the topic of introducing fluoridation to the central water supply.

Fluoridation, I've learnt, is an inflammatory word.

Few things in the field of dentistry split clinicians, parents and the public like the topic of introducing the ‘F' word to the central water supply. From high street dentists to Nobel Prize winners - Dr Arvic Carlson, winner of the 2000 prize for medicine, branded water fluoridation "against all principles of modern pharmacology", - opinions on water fluoridation flow freely.

Campaigners in the anti-fluoridation corner argue that its introduction to drinking water is indiscriminate mass medication. The chemical, critics say, is linked to an increase in the risk of bone fractures, decreased thyroid function, lowered IQ, arthritic-like conditions, dental fluorosis and osteosarcoma. Most damningly, they claim, it does nothing to improve children's teeth.

For many dental professionals, it's a moot point. Faced with the UAE's soaring rate of paediatric caries, they are united on one issue; something needs to be done. Yet the Ministry of Health, cowed under the prospect of a public backlash, remains adamant the country's water supplies stay untouched.

Here are the facts. Several large studies have proved that water fluoridation works. Admittedly, blanket fluoridation assumes people have neither the knowledge nor the means to improve their oral health, but in the UAE, the latter point is true. With caries, the health gap mirrors the wealth gap. The poorer the child, the higher the chance of untreated dental disease, and the scare tactics of the more affluent are impacting on less prosperous families. The longer fluoridation plans - or any plans targeting paediatric oral health - are given the brush off, the more severe the problem becomes.

Of course, in the furore over fluoridation, potentially the biggest issue has been overlooked. Very few people in the UAE actually drink tap water. If the Government bows to industry pressure and goes ahead with plans, the biggest beneficiaries are set to be the bottled water companies. A more practical solution might be to spend the money on providing fluoridated bottled water in schools at a subsidised rate. The public - and parents - retain choice, and children receive the benefits of fluoride in their formative years.

If only all dilemmas could be so simple.

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