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(05/01/16) A summary of 'Cochrane Collaboration systematic review of water fluoridation 2015' has been posted in Reports.
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(16/04/14) A critique of 'One in a Million: The Facts' has been posted in Reports.
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(16/04/14) 'Fluoridation: Popularity' has been posted in the Archive.
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(18/04/10) New fluoridation scheme for Southampton


(18/04/10) The Reports and Archive sections have been updated with further documents and links


(11/07/09) A critique of Prof. Newton's report to South Central SHA has been posted in Reports.
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(28/09/08) A critique of the South Central Strategic Health Authority Consultation Paper on Water Fluoridation in Southampton, has been posted in Reports.
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(07/09/08) A response to the Chief Dental Officer's 'Dear Colleague' letter of guidance for new schemes, endorsed by scientists from the York review, has been posted in Reports.
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(23/06/08) Isle of Man has announced on 12th June that it will not be fluoridating its water supply
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Fluoridation: Popularity

The pro-fluoride authorities say it is a minority who oppose fluoridation.
What is the evidence?

Some years ago there was a survey of MPs' views undertaken by the British Fluoridation Society. It reported that 70% of MPs were in favour. In fact, 70% of those who replied to the survey were in favour: less than 50% replied.

The 2003 Water Bill to remove the water companies' veto on fluoridation schemes and allow health authorities to decide produced sizeable majorities of both Houses in favour. The Commons also voted 284:181 against banning fluoridation, which was 61% of the actual but only 44% of the total possible vote.

On the issue whether elected local authorities rather than HAs should decide to fluoridate, the vote was much closer: 243:200, i.e. 55%/37% in favour of HAs, 45%/31% in favour of local authorities.

What about popular opinion? The 2nd edition of One in a Million, produced in 2004 by the British Fluoridation Society, gives the figures for 5 opinion polls between 1985 and 2003, showing public support rising from 71% to 79% (1992) and then down to 67%. They were conducted by Gallup or NOP, but sponsored by bodies supporting fluoridation with the wording "Do you think fluoride should be added to water if it can reduce tooth decay?" The document itself is unreliable in its treatment of the science and some other issues. It would be interesting to know how the figures would have come out if the wording had been "if it can be shown not to cause significant harm". On the other side, Lady Byford cited in the Lords in July 2003 an informal survey done by the Leicester Mercury which showed 94% against fluoridation; and there have been other similar figures reported. It appears to depend who commissions the survey and/or what wording and methods they use. It is not clear what the comparative figures are for local decisions in recent years which have been blocked (where necessary) by water companies: but these will not give percentages of the popular vote, since they were taken by councils.

The London Assembly completed a consultation exercise in November 2003, with an opinion poll by TNS (1,000 people, by telephone) asking 7 fair-sounding questions.

  • 91% didn't know they weren't fluoridated at home.
  • 38% were pro-F (12% strongly); 30% were anti-F (16% strongly).
  • 74% had heard F could benefit: 53% agreed (20%); 11% disagreed (6%).
  • 41% had heard F could harm: 33% agreed (12%); 22% disagreed (6%).

The Scottish Executive published a consultation document in September 2002, "Towards Better Oral Health in Children". An independent analysis for the Scottish Executive by George Street Research, produced in early 2005, reports on "a very large consultation exercise with a vast volume of responses", whose main thrust was for a comprehensive oral health strategy involving a major education campaign on e.g. diet, fizzy drink promotion and advertising of sugary products. It recommended "further research and more consideration of the issue of fluoridation of water", while stating that this "remains controversial and careful consideration . . is indicated". "Where a view was clearly provided, the vast majority (97%) of responses from individual members of the public were against fluoridation of water. This contrasts with the large majority (93% in favour) of responses from dentists and NHS Boards/Trusts/Agencies . . Of the remaining respondents, 25% were pro fluoridation of water." Reservations centred on "potential health risks and the lack of individual choice." (Respondents were of course self-selected.)

The U.S.A. experience is instructive. The full picture is hard to come by, but the Fluoride Action Network website (which opposes fluoridation) gives the following quotations under the entry 'Communities which have Rejected Fluoridation Since 1990':

  • '"In about 60% of 2000 referenda held in the U.S. since 1950, fluoridation has been voted down." -- Zev Ramba, Washington Bureau Editor of AGD Impact (the publication of the Academy of General Dentistry). Quoted in the Chemical & Engineering News (8/1/88).
  • "Avoid a referendum. The statistics are that 3 out of 4 fluoridation referenda fail." -- Susan Allen, RDH, BS Fluoridation Coordinator, Public Health Dental Program, State Health Office, Florida. May 7, 1990. . . .
  • "The fact that nearly 3 out of every 5 communities which vote on the issue have rejected fluoridation, year after year, does in all likelihood represent a collective judgment on the part of the public that, when all things are considered, fluoridation is not an acceptable public health measure." -- Edward Groth III, PhD Dissertation, Stanford University, May 1973.'

There follows a list of 118 communities which have voted to reject fluoridation between March 1990 and June 2003. These need to be set alongside the US communities which pro-fluoride briefings tell us have decided to fluoridate. It is hard to tell the size of the populations involved; some, like Flagstaff, Colorado Springs, Davis, Worcester (Mass.), Spokane, Wilmington, Santa Barbara, Wichita, Boca Raton, Santa Cruz, Albany, Bellingham, Palm Beach County are substantial names. Picking out the Worcester reference at random, one sees that the vote had been 56% against fluoridation (the 5th rejection since the 1950s), on a "shoestring" budget of volunteers, against a $400,000 pro-fluoride campaign, which may be a typical pattern. America is probably the country where fluoridation is most heavily promoted, which makes the results interesting.

E.B.
11.03/5.05/8.06.[3.14]

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