Busting the myths about fluoride in Northland’s water
Fluoride is a bit of a hot topic in many areas of the web, with strong voices in both the pros and cons column.
Officially, New Zealand is one out of a number of governments that supports fluoridated drinking water. There is an active push to get more of the country’s water supplies fluoridated, especially in rural areas such as Northland with a history of oral health problems.
So is fluoride safe, and why is there such a debate? Let’s take a look.
Read more: “Non-fluoridated water a dental risk for Northland kids”
Facts: Is fluoridated water safe for Northlanders to drink?
So, the short answer is generally yes.
But, to help you fully understand the ins and outs of fluoridated water, we’re going to talk about what it is and what it does, and offer you a number of links to reliable sources so you can see where we’re getting our information from. When researching anything online, it’s always good to check what sources someone is relying on!
First, what is fluoride?
Fluoride is actually a totally natural substance. Your body already contains it, in your bones and teeth. But, it’s also naturally found in places like soil, plants, rocks, air and, of course, water.
Governments around the world have been using fluoride in water for decades to help prevent tooth decay. You see, fluoride in water can act like a repair kit for teeth, neutralising acids in our mouths and helping repair damage to teeth before it becomes permanent. (Source)
Has it worked?
People have been studying fluoridation for years, and the results do indicate that it can have a positive effect on oral health.
Water fluoridation can reduce instances of dental caries in both baby and adult teeth by as much as 60%. (Source)
Children who live in Northland without a fluoridated water supply were found to have higher rates of early childhood caries compared with similar-aged children in Auckland who did have such a supply. (Source)
Fluoride in public water supplies has been endorsed by a huge number of important community health organisations, including the World Health Organisation (WHO), NZ Dental Association, New Zealand Nurses Organisation, Te Ao Marama – the Māori Dental Association, Royal New Zealand Plunket Society, the US Centre for Disease Control, and British Medical Association. (Source)
So what does water fluoridation look like?
It’s where fluoride is added to the public reticulated water supply, up to between 0.7 ppm (parts per million) and 1.0 ppm. In New Zealand, our natural water supply just doesn’t contain enough of the substance to have a noticeable effect on Kiwi’s oral health, so we choose to add more.
That level of fluoridation is the recommended amount for optimal protection, and it is monitored to keep it at that level.
Known side effects of fluoride
There are some known side effects to consuming too much fluoride, and these have become a focal point of some of its opponents. We will detail these side effects below so you are fully informed, but before we do keep in mind:
There is no substantial scientific evidence to suggest that fluoridating water to the levels we’ve discussed causes significant health problems.
To quote Sir Peter Gluckman, Chief Science Advisor to the NZ government 2009-2018: “It is absolutely clear that at doses used in New Zealand to adjust the natural level to one that is consistent with beneficial effects (0.7-1.0ppm), there is no risk from fluoride in the water.”
Known side effects of fluoride
Dental fluorosis: This cosmetic side effect can result in white spots appearing on the surface of your enamel, and tends to happen almost entirely to young children whose teeth are still coming through. Too much fluoride ingestion can cause a “hypomineralisation” of tooth enamel as it’s forming, which is what gives it the spots.
Skeletal fluorosis: With long-term exposure to high levels of fluoride may come skeletal fluorosis, which affects bones, not teeth, causing joint pain, stiffness or impairment. This is quite a rare condition.
Fluoride toxicity: Acute fluoride toxicity may result in gastrointestinal pain, nausea and vomiting, or diarrhoea. Renal and cardiac dysfunction, coma and death have been noted in the most severe cases.
Most of the time, these symptoms are caused by the swallowing of toothpaste or mouthwash, not public water. There are no reported cases of disfiguring fluorosis in NZ due to public water supplies (source), and more than 80% of fluoride toxicity in children under six years is due to ingestion of toothpaste and mouthwash (source).
Significant long-term exposure can also occur due to: contamination of drinking water after fires or explosions, consuming multiple higher-level sources of fluoride (e.g. excessive toothpaste use), or long-term consumption of water that contains more than the recommended limit (source).
So why is there so much opposition in certain countries?
This is a harder one to answer because there are quite a few reasons. For some, it’s due to misinformation or a lack of education. For others, it’s a matter of choice.
Some common opposition points include:
If fluoride is in the water, it’s hard to perfectly control the dose because people drink different amounts of water. People may also consume fluoride from multiple sources, and adults and children would be consuming the same dosage per glass of water. Some experts suggest this is too great a risk for a public water supply.
The benefits of fluoride are more apparent when applied topically rather than when ingested, meaning there may be more logical ways to offer people appropriate levels of fluoridation without it being in the water.
In lower-income areas or areas with higher rates of dental problems such as Northland, the biggest issues tend to stem from an absence of, or inability to afford, dental care rather than a lack of fluoridation.
Some communities just want to have a choice – rather than the NZ government making a decision on their behalf.
These types of concerns are certainly valid, and we aren’t going to dispute them here today – especially the debate around community choice.
The official line right now in New Zealand is that fluoridated water is safe and beneficial. Should scientific debate one day change its recommendations (e.g. from water to something else), then we can, as a country, take another look at our fluoridated water supplies. That is, after all, what it means to learn and grow.
What if I don’t live in an area with a fluoridated public water supply?
There are plenty of regions in Northland that don’t have access to fluoridated water. That is the nature of rural life.
Some websites have in the past recommended that community members living in such areas take fluoride supplements like tablets, chews or lozenges. This isn’t recommended unless a medical professional has personally suggested that you should take them – it can increase your risk of side effects.
If your local water supply hasn’t been fluoridated yet, or you don’t get your water from a public source (such as those with rain tanks), you will need to take care to maintain good oral health standards in a more general sense. That means:
Brushing your teeth twice a day for two minutes.
Remember to brush your tongue and gums, too.
Using fluoridated toothpaste.
Rinsing your mouth regularly with antibacterial mouthwash – try once a day, e.g. after eating.
Flossing at least once a day.
Getting a regular dental check-up, at minimum once a year.
For more oral health advice, check out these links:
Or to book a dental appointment, we’re here in Whangarei on Maunu Road! Call us on 09 430 0707 or book online today.