My Lords, I extend a warm welcome to the noble Lord, Lord Stevens, although like my noble friend Lady McIntosh, I respectfully disagree on the topic of water fluoridation, a measure that I strongly oppose and that I will focus on tonight.
It is disappointing that mandatory fluoridation has been slipped, virtually unnoticed, into the nether regions of such an important Bill, without its own debate and without proper scrutiny. Moreover, it all seems very rushed. I stand before noble Lords today not as a scientist or a connected party of a lobby group but as someone who has grave concerns about the risks posed by widespread water fluoridation. I contend that high-quality evidence that has come to light in North America since 2017 suggests that fluoride can damage the developing brain and reduce IQ. I conclude that water fluoridation has not been adequately researched by those who have initiated the Bill. The practice cannot be considered safe and should not be extended throughout the country.
In Europe the only countries that have agreed to water fluoridation are Ireland and the UK, with 10% population coverage, with Spain, Poland and Serbia having done so to a very minor extent. In studies in 1999 and 2001, the Centers for Disease Control and Prevention acknowledged that fluoride’s benefits are mainly topical, not systemic. There really is no need to swallow fluoride or put it in drinking water, when topical treatments like fluoridated toothpaste are available.
Children, particularly bottle-fed babies, are unfortunately being overexposed to fluoride. Infants consuming formula mixed with such water receive the highest exposure to fluoride by body weight—a dosage 100 to 200 times higher than a breastfed baby. This overexposure leads to dental fluorosis, or discolouration of the enamel, when the permanent teeth erupt. Since we have now learned that fluoride crosses the placental membrane, it is evident that the foetus receives an even higher exposure than a bottle-fed infant at a more vulnerable time.
Proponents claim that over 60 years of research has demonstrated that the measure is safe and effective. However, most of that research has focused on the hard tissues: the teeth and bone. It is only recently that high-quality research has focused on other tissues, with disturbing results. According to recent US Government-funded studies published in leading global journals—Bashash, 2017 and 2018; Green, 2019; and Till, 2020—fluoride has the potential to damage the developing brain of both the foetus and the infant, leading to lowered intelligence and increased symptoms of ADHD. Making these observations even more alarming is that the damage was observed in fluoridated communities in Canada—a country that fluoridates at 0.7 parts per million, versus 1 part per million in the UK. The Till paper showed an IQ decline of 9 points among bottle-fed children in fluoridated versus non-fluoridated communities. These findings are so serious that they make any discussion of dental benefits of this practice moot. You can repair a damaged tooth but not a damaged brain.
The irony of the Bill’s proposals is that they will harm most those whom they seek to help. Those most likely to suffer from poor nutrition, and thus most likely to be vulnerable to fluoride’s toxic side-effects, are the less well-off, who are the very people being targeted by the proposed fluoridation programmes. We should be spending our efforts trying to increase the access to dental care for low-income families and invest in programmes such as Childsmile in Scotland.
In his written evidence to the recent White Paper, Professor Stephen Peckham, government adviser to the current Select Committee on Health in the other place, chaired by Jeremy Hunt, stated that
“if the Secretary of State was looking for ways to improve oral health then water fluoridation should not even be considered given its lack of effectiveness. More attention should be given to schemes such as Childsmile in Scotland which has been proven to reduce inequalities, reduce admissions for tooth extractions and provide broader public health benefits beyond oral health. Such a scheme links very clearly to addressing obesity issues as well”.
Professor Peckham rebuts government claims in the White Paper that water fluoridation is proven to improve oral health and reduce oral health inequalities. He argues that such claims are based on inconclusive evidence and studies predominantly carried out pre 1975, before the wide use of fluoride toothpaste. Peckham further argues:
“We should not be considering any new schemes given the increasing amount of evidence linking fluoridation to harmful health effects.”
Only eight years ago, the Government made a decision to transfer decisions on this issue from the NHS strategic health authorities to local government. The specific reason given was that local communities should have a stronger say. This Bill reverses that position and reverts to the centralisation of control with the DHSC.
Surely, if health measures are to be imposed on the individual and if the community’s final say in the matter is removed, the scientific evidence should show overwhelmingly that the measure is both beneficial and safe. In the case of water fluoridation, I do not believe it is either. At the very least, I urge a delay in proceeding with this measure until the National Toxicology Program in the US—which for the last five years has been undertaking a systematic review of the fluoride neurotoxicology studies—publishes its report, expected in early 2022. The public will not easily forgive us for rushing ahead without availing ourselves of the best scientific research on the matter.
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