Fluoride Free New Zealand and New Zealand Doctors Speaking Out for Science take legal action against Hastings District Council over Fluoridation.
Massey University analyst Caroline Fyfe and Massey University Professor, Barry Borman have recently published a paper in the New Zealand Medical Journal which claims that fluoridation is cost effective In New Zealand. We believe the analysis was poorly conducted and failed to consider some of the most basic aspects. Therefore we have sent the authors the following letter:
Dear Caroline Fyfe and Professor Barry Borman
It is with disappointment that we read your paper just published in the New Zealand Medical Journal about the cost of water fluoridation. We hope that you can re-evaluate this analysis using more appropriate and extensive data, which are readily available.
Our first concern is your oversight in using the highly inappropriate New Zealand 2009 Oral Health Survey to calculate the difference in tooth decay rates between fluoridated and non-fluoridated areas. This survey clearly states that it was not designed to be used as a study on dental health and fluoridation, as it was taken as a snap-shot in time without consideration of where children had lived their entire lives.
The publication states:
“It is important to note that it was not one of the objectives of the 2009 NZOHS to compare the oral health status of people by fluoridation status, and therefore the survey cannot be taken as a fluoridation study. The following results are a snapshot in time and constitute an ecological analysis based on current place of residence. As such they do not take into account lifetime exposure to fluoridated and non-fluoridated water supplies. Individuals who currently live in fluoridated areas may have spent time in non-fluoridated areas, and the reverse is also true. Furthermore, there may be other confounding factors that haven’t been taken into account.”
While it may have been valid for the Ministry of Health to take a snap-shot in time, had they been looking at a large population, this was not the case this time. This survey only contained about 60 people in each age group. In comparison, the New Zealand School Dental statistics that are collected every year, and freely available on the MoH website, have about 45,000 children in each age group.
Therefore, it would be appropriate for you to re-evaluate your analysis using the NZ School Dental statistics or looking at New Zealand studies completed over the past ten years; Mackay and Thomson 2005, Schluter 2008, Kanagarathnum 2009.
Our second criticism of your analysis is that you have neglected to calculate the cost of covering the permanent dental fluorosis for 40% of New Zealand’s children, which is an epidemic. In addition to the New Zealand studies mentioned above, the recent Cochrane Review, Water Fluoridation to prevent tooth decay, the UK Government’s York Review and others have found that fluoridation seriously increases the amount of children with some level of dental fluorosis. As the NZOHS itself states, it cannot be used to ascertain the differences in dental health between fluoridated and non fluoridated areas, which includes fluorosis assessment.
The Cochrane Fluoridation Review estimated that approximately 40% of the population had some form of dental fluorosis when consuming water fluoridated at 0.7ppm (parts per million). Of the entire population, they estimated that 12% had fluorosis that affected appearance, which can affect self-esteem and life outcomes (including employment). At very least, the basic cost of repairing this external permanent damage to teeth needs to be calculated as part of cost analysis of water fluoridation.
Your analysis failed to include the huge costs of promoting and defending fluoridation. The now defunct National Fluoridation Information Service cost New Zealand tax payers $1,000,000 per year for the three years it was running. The cost of the Hamilton and Hastings referenda were reported as $50,000 for each respective District Health Board. Several other DHBs across NZ have spent large sums in fluoridation propaganda campaigns in the past five years.
Nor does your analysis make any mention of the cost of the mounting list of other adverse health effects of consuming fluoridated water. An estimate of fluoridated water’s contribution to hypothyroidism treatment would be a worthy inclusion, apart from all the other unknown costs of other adverse health effects.
Finally, we consider an analysis of the Ko and Thiessen Critique of Recent Economic Evaluations of Community Water Fluoridation, published in the International Journal of Occupational and Environmental Health in 2014 is another necessary inclusion.
We would appreciate if you would please respond to these criticisms.
Fluoride Free New Zealand
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