News from Switzerland

Friday 09 May 2003

Basel to stop fluoridation of drinking water

The city of Basle in Switzerland is preparing to end the fluoridation of municipal drinking water in the autumn. The local parliament has voted to stop the practice, due to high costs and lack of evidence that fluoride cuts tooth decay.

Basel is the only Swiss canton to add fluoride to its drinking water, a practice that was started some 50 years ago in a bid to tackle tooth decay.

In Switzerland, each municipality has its own drinking water supply, and was responsible for adding the precise quantity of fluoride recommended to prevent tooth decay. In very large quantities fluoride can be poisonous and even the addition of small amounts are claimed to cause dental fluorosis or mottling of the teeth. The true impact of this has long been a source of contention among scientists.

The other smaller municipalities found the costs associated with administering the practice too high. Now BasleÕs officials have decided that the evidence that fluoride can stop tooth decay is far from concrete and want to see an end to the practice. In fact, a local government report found that tooth decay had increased in BasleÕs children between 1996 and 2001.

Statistics showed that the number of caries were falling before the introduction of fluoridation,Ó Dr Urs Buxtorf of the Basle City and Canton laboratory told edie. ÒAlso, for every 1,000 litres of drinking water that is supplied to homes, only two litres are drunk, which means that most of the fluoride in the environment goes back into the environment.

Two of the key reasons supporting GSK's recommendation were:

1) Lack of evidence that water fluoridation is more effective than salt fluoridation in reducing tooth decay.

As noted in GSK's report:

"No study or investigation can belay clearly that water fluoridation obtains better results as a measure to reduce tooth decay than other means of base (systemic) fluoridation" (i.e. salt fluoridation).

It is clear throughout the report that the GSK had developed serious doubts about the effectiveness of water fluoridation. Adding to these doubts were recent findings showing that tooth decay had risen in Basel's children since 1996, coupled with an absence of any evidence showing Basel to have a lower rate of tooth decay than other Swiss cities (most of which have - although increasing - rates of tooth decay).

In 1999, the GSK had asked public dental clinics to investigate whether Basel had a lower rate of tooth decay than "areas or cities with similar population structures, such as or St. Gall" which fluoridate their salt. Four years later, these investigations had yet to be conducted.

According to GSK's President, Jurg Merz, "we said [in 1999] that we would like to get more results and comparisons. Four years later they were not able to bring them forward. So the GSK discussed the case again. We advised the whole parliament to stop (water) fluoridation."

As noted in the report, the lack of evidence that water fluoridation had benefits over and above those obtained from salt fluoridation (a practice which the GSK considered less intrusive), undermined the justification for the "intervention into personal freedom" that water fluoridation presented.

According to board member Tobias Studer,

"The freedom of the individual to choose the appropriate prophylaxis method itself was also a major point in the debate... While fluoridated water as supplied by the city has virtually no competition, it is possible to buy non fluoridated (and non iodized) salt anywhere."

2) The inefficiency/wastefulness of water fluoridation.

As noted in the GSK report, "only a minimal part of so-called 'drinking water' is used for drinking and cooking." The GSK estimated that "over 99 percent of the fluoride" added to water is never consumed by humans, leading in turn to "an unnecessary load on the environment."

According to GSK's president, Jurg Merz, "More then 99% of the water is not drinking water but is used for washing cars, cleaning stairs, showering, to pour on flowers and so on. Fluoride is poison that loads our rivers."

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