Water fluoridation: public health and politics

Transcription

1 Water fluoridation: public health and politics

2 The reality of tooth decay By the age of 5, almost half of Australian children have already suffered tooth decay. By the age of 8, this rises to more than two thirds. Dental admissions are the highest cause of acute preventable hospital admissions for children. Early childhood tooth decay affects a child s development, behaviour and performance at school, and also impacts on their family, the health system and society. Chrisopoulos S, Harford J. Oral health and dental care in Australia: Key facts and figures Canberra: AIHW

3 Tooth decay is associated with poorer general health, difficulty in eating and poorer nutrition, greater difficulty in finding employment, days lost from school and work, poorer self-esteem and dignity, and a lower quality of life. End the decay: The cost of poor dental health and what should be done about it. Brotherhood of St Laurence, 2011

4 In , Australians spent $8.3 billion on dental costs, more than that spent on all cancers combined, and all mental illness and dementia combined. The great majority of that dental cost is a direct result of tooth decay fillings, extractions, dentures, implants, crowns and bridges, root fillings etc. Australian adults living in regional areas are about 1.7 times as likely to have no natural teeth, and those who do have natural teeth have 25% more missing teeth than people living in major cities. Around a quarter to a third of the population will have untreated tooth decay. Directly or indirectly, all Australians pay for the level of disease in our communities. Oral health and dental care in Australia: key facts and figures trends Australian Institute of Health and Welfare, 2014

5 How can we treat the problem? Spend more money on dental treatment, operating theatres, doctors providing painkillers and antibiotics? or Prevent some of the tooth decay through oral health promotion, education, and preventive measures with fluorides? Fluoride tablets?

6 The beneficial effect of fluoride tablets is mainly systemic, but fluorides prevent decay most effectively when applied topically. Most children taking fluoride tablets have only a low risk of decay, and compliance in the higher risk groups is poor. Fluoride tablets therefore only provide a small benefit to a small number of children. Fluoridated water provides a much greater benefit to people of all ages, and the benefit is additional to that provided by fluoride toothpaste.

7 The 2002 Australian Child Dental Health Survey examined 136,000 Australian children, and found that no matter which state or territory children came from, what age group they were, whether they were rich or poor or in between, whether they lived in the capital city or regionally or remotely, children who drank fluoridated water had substantially less tooth decay than children who didn't. Armfield JM, Slade GD & Spencer AJ Water fluoridation and children s dental health: The Child Dental Health Survey, Australia 2002

8 National Survey of Adult Oral Health Another recently published study was based on data collected from the National Survey of Adult Oral Health Dental examinations of 5,505 adults from around Australia found significantly less decay in adults drinking fluoridated water. These benefits were also seen in adults who had grown up prior to the introduction of fluoride toothpaste and fluoridated water. Greater benefits were shown for adults who had been drinking fluoridated water for longer. Slade GD, Sanders AE, Do L, Roberts-Thomson K, Spencer AJ. Effects of fluoridated drinking water on dental caries in Australian adults. J Dent Res Apr;92(4):

9 Despite that, Public dental care in Australia is in crisis there is now a sharp divide in dental health between rich and poor, and between those in the cities and those in the bush. Extending coverage of fluoridation to all communities of at least 1,000 people will lead to improved population health, with a dominant cost-effectiveness ratio and 100% probability of cost-savings. Prof Theo Vos, Professor of Global Health, University of Washington, Seattle Cobiac LJ, Vos T. Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia. Community Dent Oral Epidemiol Aug;40(4):

10 Inequalities vs inequities A major aim of public health is to not only reduce overall levels of disease, but also reduce health disparities and health inequities within society. But water fluoridation is controversial. Aren t there risks, and isn t science divided?

11 Every Federal, State and Territory Health Department in Australia Royal Australian College of General Practitioners National Health and Medical Research Council Royal Australasian College of Physicians Public Health Association of Australia Australia s National Oral Health Plan U.S. Centers for Disease Control Australian Academy of Science Australian Medical Association American Medical Association Australian Dental Association Royal Flying Doctor Service British Medical Association World Health Organization

12 But what do councillors say? It might protect your teeth but if you get too much fluoride your bones go brittle so you end up with a real lot of old people who might have good teeth but they can t move anywhere because their bones are fractured. Blackall-Tambo Mayor Barry Muir

13 Fluoride causes fluorosis and dementia. Rockhampton councillor and former nurse Glenda Mather

14 The benefits of fluoridating the public water supply is a myth and unsupported by science. Port Macquarie-Hastings Deputy Mayor Lisa Intemann

15 It could impact on the heart and skeletal system. Lismore councillor Vanessa Ekins Cr Ekins, a trained science teacher, also said she did not immunise her two sons now aged 14 and 16 because she feared immunisation was not safe either. Daily Telegraph

16 Fluoride is kryptonite to lovely hydrangeas. The main reason gerberas are blooming so well is that fluoride was removed from Rockhampton s water supply last year. Rockhampton councillor and nurseryman Neil Fisher

17 Am I poking fun at councillors? If politicians know little about public health and water fluoridation, is it their fault? Partly mine? Councillors are bombarded with propaganda from anti-fluoridation groups, and many are reluctant to make a tough decision when the benefits may not be seen for at least 5-10 years. And people who publicly endorse fluoridation can expect abuse and intimidation

18 Dr Kerry Chant NSW Chief Medical Officer Dr Brendan White GP dentist, Lismore Lismore Mayor Jenny Dowell

19 Paedophile Fucking wanker One day soon you will stand in the Court of Justice and you will be put on Oath. God will be your Judge. You will pay for this in eternity. You disgusting, lying, manipulative scumbag. You re not a Dentist s arsehole. You are an industry paid shill, a mole, a prostitute and a parasite and one day I will piss on your grave. A money grubbing wilfully ignorant unethical hypocrite May God have mercy on your soul. Do you own your own home? Do you own shares? Do you have an investment portfolio? We need this information for the Class Action lawsuit when we sue you. In the past people like you were shot, jailed, hung or castrated. Michael, your days are numbered pal.

20 Is this the quality of debate we expect for major public health initiatives in Australia? The decision, whether or not fluoridation, as a matter of public health designed to protect the dental health of the young, should be put into force in this State, should not be left to local authorities. It is a matter for the decision of Parliament. It follows, consistently with the views I have expressed, that to refer the matter to a forum both technically incompetent and constitutionally incapable would constitute an abrogation of Parliament s responsibility. Justice Peter Crisp Tasmania, 1968

21 Male and female regent bowerbirds Lamington National Park, Queensland