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Secret plan for fluoride in all water



MINISTERS are planning to allow fluoride to be added to all drinking water in England and Wales despite continuing concerns about the long-term health risks, leaked cabinet papers have revealed.

They have ordered the controversial move because they believe it is the best way of reducing tooth decay among children from "deprived" areas.

Only about 11% of the population receive fluoridated water and the move is certain to spark a fierce debate.

Although water fluoridation has been proved to reduce tooth decay, critics fear it may also be linked to increased risks of cancers, hip fractures, kidney trouble and even birth defects.

They see it as a form of "mass medication", leaving people no choice but to buy bottled water if they do not agree with the policy. They point out that people can look after their teeth perfectly well by using fluoride toothpaste.

The documents reveal Tony Blair is personally backing the plan to extend fluoridation.

A document signed by health and environment ministers last month concludes that opponents are in a minority and that "this minority should not be allowed to deprive health communities from opting for fluoridation by insisting on an indefinite research programme".

Ministers will introduce the change in amendments later this month to the Water Bill, allowing strategic health authorities to order fluoridation after consulting the local population.

In September the Medical Research Council, a government-funded agency, reported that more information about potential health risks, including links between fluoridation and cancer rates, was "needed by the public to make informed decisions".

The plans are so controversial that the prime minister has agreed to allow cabinet members and other Labour MPs a rare free vote on the issue. Ministers are confident, however, the changes will be supported by a clear majority, as opinion polls have consistently shown that about two-thirds of people believe fluoridation to be beneficial.

Ministers argue the measures are justified because children in fluoridated areas have much less tooth decay.

A letter from Hazel Blears, the health minister, and Elliot Morley, the environment minister, says: "Those who remain adamantly opposed would be able to use water filters that remove fluoride or buy bottled drinking water."

The letter, dated April 15, is addressed to John Prescott, the deputy prime minister, in his role chairing the domestic affairs cabinet committee.

It says: "Experience of oral health promotion projects shows that it is much harder to establish regular toothbrushing in deprived areas ' because of the costs of toothpaste and, perhaps, because of the less-ordered lifestyles lived by families."

The proposed change would transfer responsibility for deciding to treat water away from the water companies and give it to regional strategic health authorities.

Manchester would be one of the first to act. Other areas where tooth decay is a problem include inner London, south Wales, Yorkshire and the East Midlands.

Why fluoride is put in water

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What is fluoridation of water?

The addition to drinking water of chemicals based on the element fluorine to protect growing teeth in children. The chemicals, similar to an ingredient in toothpaste, also occur naturally.

What are the advantages?

According to a York University report in 2000, adding fluoride cuts the number of decayed teeth by an average of 2.25 per child. Five-year-olds in Sandwell, West Midlands, where water has been fluoridated since 1986, had an average of just 0.88 filled, decayed or missing teeth, as against 2.35 in Bolton, which had untreated water.

What are the risks?

Too much fluoride can cause teeth to become mottled and brittle. Some studies suggest it may be linked to hip fractures and bone cancers and may interfere with the thyroid gland. Opponents allege impurities from manufacturing contaminate supplies in drinking water.

Where is water fluoridated?

In the United States more than 150m people drink fluoridated water, although more than 50 cities or towns have withdrawn fluoride from supplies since 1990. In Ireland 70% of the population are on fluoridated supplies, while elsewhere in Europe, including France and Germany, fluoride is added to table salt ' although people can choose unaltered salt.

How many people in Britain drink fluoridated water?

About 5m. Many in Birmingham and the West Midlands, Tyneside, Northumberland and Lincolnshire have fluorides added to their water. A further 1.5m receive water which is naturally fluoridated.

How does it protect teeth?

During the formation of teeth, fluoride swallowed in water becomes incorporated into enamel, making the tooth less prone to decay.

What is added to water during fluoridation?

Only two chemicals, hexafluorosilicic acid and disodium hexafluorosilicate, can be added legally to drinking water. Where water is treated, the legal limit is one part per million. In America four times that amount can be added.

Where does fluoride occur?

Some high natural concentrations are found in endives, curly kale and tea. Water in parts of China contains eight times the British tap water limit.

When did fluoridation start?

In America in 1945, after scientists noticed that people in areas with naturally higher levels of fluoride in water had healthier teeth. The process became notorious in Stanley Kubrick's 1964 film Dr Strangelove, in which General Jack Ripper launches a nuclear strike against the Soviet Union fearing that fluoridation is part of an "international communist conspiracy to sap and impurify all of our precious bodily fluids".

 
 
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Leader: Leave water alone

For decades a debate has raged about putting fluoride into Britain's water supplies. Dentists say there are proven benefits in reducing tooth decay among children, giving them healthier teeth for the rest of their lives. Some experts warn, however, of possible links with bone cancer, stomach complaints and even birth defects. Underlying that debate has been an important civil liberties issue. Critics say fluoridation shows the nanny state at its worst. Does the government have the right to inflict what amounts to mass medication on the population just to protect children whose parents fail to ensure they care properly for their teeth?

Fluoridation is a controversial issue for the government to take on, having got its fingers burnt on genetically modified foods. At present 11% of people in Britain have fluoridated supplies, in the majority of which fluoride is artificially added. No new areas have been fluoridated since the water industry was privatised under the Thatcher government. The proposed legislation will allow the 28 strategic health authorities in England to order the fluoridation of water after local consultation. There is, however, little conclusive research either on the benefits, or the possible health costs, of such a policy. In America, the shift is in the opposite direction, more than 50 towns and cities having withdrawn fluoridated supplies since 1990. In France and Germany fluoride is added to table salt, but people have the choice of not using it, or of buying a non-fluoride product.

At a time when the government talks of modernising healthcare and transforming the 1948 model of the NHS, fluoridation is a curiously old-fashioned policy, a throwback to the days when people had neither the knowledge nor the means to make themselves healthier. Today, the shelves in every supermarket are stacked with fluoride toothpastes. Ministers talk of enhancing consumer choice but are proposing a policy that offers no choice. Evian and Malvern must be rubbing their hands. If the government goes ahead with the plan, the main beneficiaries will be the bottled water companies.