This graphic showing the fall and rise of children’s cavities in the past decade is interesting and revealing. According to this South Australian study, since 1997 there is an ongoing upswing in dental cavities. The interpretation given by Professor John Spencer, the director of the Australian Research Centre for Population Oral Health is rather crude and unconvincing. Although he concedes that sugary drinks and snacks play a role, he emphasises the importance of the widespread use of bottled and filtered water without fluoride to protect teeth. In other words not enough fluoride is reaching the children.
This is only one interpretation and probably an incorrect one. A more convincing way of interpreting the data would be by taking into account the findings of a number of studies.
At the website www.rag.org.au you find a section on Fluoride. Under the heading ‘Teeth’ of this section you find a number of studies summarised. One such a summary is by professor Paul Connett from the university of New York. He refers to another South Australian study where professor Spencer also participated. Using the data of this study Paul Connett shows that fluoride is ineffective in protecting teeth as the rate of cavities in children from a fluoridated area is well near the same as in children from a non-fluoridated area.
A similar finding shows up in an Indian study (also under ‘Teeth’) and here it becomes clear that especially calcium protects teeth and not fluoride.
Many children in fluoridated areas are getting too much fluoride from all sources combined. Quite a few studies show this and Paul Connett refers to them. This over-dosage leads to low level fluoride poisoning, which shows up as white specks or flecks on the enamel. When it progresses the specks grow into opaque paper white areas and from there it can get worse and causes discolouring of teeth. This is permanent damage to the enamel and is called dental fluorosis. A study in Tucson, Arizona US, showed that more fluoride intake caused more dental decay, not less. This higher fluoride intake was at levels causing dental fluorosis in other studies.
Strangely, studies comparing children in fluoridated areas with non-fluoridated areas are always focussing on cavities only, while totally ignoring dental fluorosis. In other words these studies do not give a reliable picture of oral health.
Let us return to this graphic of more decay in children’s teeth from 1997 onwards. What do we know about this period? It was the time that the home computer was widely introduced, followed by game consoles. Children were glued to the screen by television, computer and game console while munching snacks and drinking soft drinks. Furthermore, children take soft drinks to school nowadays and the school canteens are loaded with sugary snacks. Result: an epidemic of fat youngsters with poor oral health.
If we combine all these findings how would this help us in interpreting the graphic published in The Sydney Morning Herald?
- If the correct daily fluoride dosage had been given, then the influence of fluoride would have been negligible and the dental decay would have been from the huge sugar intake via soft drinks, sugary snacks, biscuits, chocolates etc. and insufficient daily teeth cleaning
- If the fluoride dosage had been below the correct daily amount, then again the dental decay would have been solely from sugar intake and insufficient teeth cleaning
- If on the other hand the correct daily fluoride dosage had been regularly exceeded, then dental fluorosis might have played a contributing role to the formation of cavities in addition to sugar intake and poor cleaning of teeth.
In all this a German research should be kept in mind which showed that it is impossible to distribute a specific dosage of fluoride via the reticulation system to all households. There is no reason to assume that we would do any better here in Australia.
So, all in all the suggestion from professor Spencer to intensify water fluoridation would be counter productive. The correct approach would be to stress the importance of regular teeth cleaning and to reduce drastically the amount of sugar that is being consumed.
by H. Julius
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