Water fluoridation by country
Most European countries including Italy, France, Finland, Germany, Sweden, Netherlands, Austria, Poland, Hungary and Switzerland do not fluoridate water.
[12] However, a recent study funded by NHS found no significant difference between individuals who receive fluoridated water and those who don't in terms of missing teeth and reducing social inequities.
[19] Currently about 372 million people (around 5.7% of the world population) receive artificially-fluoridated water in about 24 countries, including Australia, Brazil, Canada, Chile, Republic of Ireland, Malaysia, the U.S., and Vietnam.
[1][20][21] 57.4 million people receive naturally occurring fluoridated water at or above optimal levels in countries such as Sweden, China, Sri Lanka, Finland, Zimbabwe and Gabon.
[20] Cessation of water fluoridation has been demonstrated in scientific studies such as a recent one in Calgary, Alberta, to result in increased rates of dental decay.
[25] While fluoridation can result in mild dental fluorosis, this effect is barely detectable and causes no concerns with the appearance or health of teeth.
[29][30] Legislation around mandatory fluoridation was introduced in 2002, but has been delayed since then pending further research after opposition from water companies, municipalities and the public.
[1] Many areas in China have fluoride at levels far higher than recommended due to natural occurrence or industrial contamination, which has resulted in a large amount of skeletal fluorosis.
It was resumed only in the Fangcun district of the city, but was halted in 1983 after opponents claimed that fluoride levels were already sufficiently high in local foods and tea.
[37][38] Due to naturally-occurring fluoride, both skeletal and dental fluorosis have been endemic in India in at least 20 states, including Uttarakhand, Jharkhand and Chhattisgarh.
The programme includes surveillance of fluorosis in the community, training and manpower support, establishment of diagnostic facilities, treatment and health education.
The Indian Council of Medical Research has formed a task force on fluorosis to address issues related to prevention and control.
[45] In 2002, the Union of Local Authorities (ULA) and others petitioned Israel's High Court to stop the Health Ministry from forcing cities to implement water fluoridation.
It seems that CWF was stopped for political reasons, and the lack of fluoride has led to an increase in dental problems which can cause systemic health issues.
[67] Many European countries have rejected water fluoridation, including: Austria, Belgium, Finland, France, Germany, Hungary, Luxembourg, Netherlands, Northern Ireland, Norway, Sweden, Switzerland,[68] Scotland,[69] Iceland, and Italy.
(Nell A, Sperr W. Fluoridgehaltuntersuchung des Trinkwassers in Osterreich 1993 [Analysis of the fluoride content of drinking water in Austria 1993].
[99] In 1957, the Department of Health established a Fluorine Consultative Council which recommended fluoridation at 1.0 ppm of public water supplies, then accessed by approximately 50% of the population.
[101][102] The statutory instruments made in 1962–65 under the 1960 Act were separate for each local authority, setting the level of fluoride in drinking water to 0.8–1.0 ppm.
[105] Implementation of fluoridation was held up by preliminary dental surveying and water testing,[106] and a court case, Ryan v. Attorney General.
Ryan was represented in court by Seán MacBride who argued that fluoridation was an infringement of human rights since people had no option but to drink it.
[108] In 1965, the Supreme Court rejected Gladys Ryan's appeal that the Act violated the Constitution of Ireland's guarantee of the right to bodily integrity.
In 2000, representatives of the Norwegian National Institute for Public Health reported that no cities in Norway were practicing water fluoridation.
They recommended other ways of reducing tooth decay (improving food and oral hygiene habits) instead of fluoridating tap water.
[133] The following UK water utility companies fluoridate their supply: Earlier plans were undertaken in the Health Authority areas of Bedfordshire, Hertfordshire, Birmingham, Black Country, Cheshire, Merseyside, County Durham, Tees Valley, Cumbria, Lancashire, North, East Yorkshire, Northern Lincolnshire, Northumberland, Tyne and Wear, Shropshire, Staffordshire, Trent and West Midlands South whereby fluoridation was introduced progressively in the years between 1964 and 1988.
[133] Surveys had found that the majority of surveyed Southampton residents opposed the plan, but the Southampton City Primary Care Trust decided that "public vote could not be the deciding factor and that medical evidence shows fluoridation will reduce tooth decay – and failed to back up claims of serious negative side effects".
[139] In September 2021, the UK's chief medical officers concluded that fluoridation of water supplies would cut tooth decay.
Some municipalities, such as Portland, Oregon, have chosen not to fluoridate their water, citing concerns over potential health risks and the ethical implications of mass medication.
[172] Conversely, areas like San Francisco, California, have maintained their fluoridation programs, emphasizing the public health benefits, particularly for low-income populations who may have limited access to dental care.
[190] In 2014, the Prime Minister's Chief Science Advisor and the Royal Society of New Zealand published a report on the health effects of water fluoridation.
[192] In late July 2022, Director-General of Health Ashley Bloomfield ordered 14 territorial authorities to add fluoride to their water supplies.
