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As even the most ‘fluoride friendly’ countries begin to rethink their positions, a new report signals that widespread water fluoridation may once again be on the cards for the UK. Tellingly, the report relies on statistical smoke and mirrors to draw its conclusions while bringing little new data to the table – and overlooks most fluoride-associated health problems.

Pushing against the anti-fluoride tide

To be charitable, the UK government must be fond of irony. When, in the USA, “Citizens in Wichita, Kansas and Portland, Oregon voted NO on water fluoridation; Connecticut, South Carolina, and Minnesota are looking at lifting mandatory fluoridation rulings”; when in Queensland, Australia, 15 regional councils are refusing to fluoridate or are halting the practice, encouraging other parts of Australia and New Zealand to follow their lead; when even the most pro-fluoridation administrations in the world, in other words, are following Europe’s lead and ditching fluoride – the UK government is heading in completely the opposite direction.

So is its renewed fluoride fervour based on groundbreaking new evidence? Irrefutable data proving once and for all that fluoride is both safe and good for our teeth, perhaps? Does the new report, published by Public Health England (PHE) offer a persuasive case that artificial fluoride added to the water supply (“adjustment of fluoride levels” in PHE’s words) is not a medicine?

Smoke and mirrors

In a word: no. The PHE report is based on an analysis of area-based fluoride intake, rather than individual intake, and the areas chosen for study are as artificial as hexafluorosilicic acid itself. The vital point here is that this is not a real-world study in any sense of the word: the study populations, results and conclusions are plucked almost entirely from the statistical netherworld. Here’s a flavour of the report’s methodology: “The Drinking Water Inspectorate provided the boundaries of all English water quality zones (WQZs) in digital format with a binary variable attached indicating whether they were subject to fluoridation schemes in 2012. Using ESRI ArcGIS geographic information systems (GIS), the population weighted centroid for each 2001 LSOA in England was assigned a fluoridation status – fluoridated yes/no – depending on the WQZ it was located within...” Any UK citizen wishing to understand how PHE reached its uncritically reported pro-fluoride conclusions is confronted by a brick wall of statistical jargon.

Ignoring the evidence

Not only is the report unnecessarily opaque scientifically, but it also commits the cardinal sin of omitting data it doesn’t like. Here are some of the fluoride-associated health effects not even mentioned in the report:

PHE versus the facts

As well as torturing the data and ignoring most of the evidence, PHE concludes that “there is no scientific difference between naturally occurring and added fluoride in the water that comes out of consumers’ taps” – a plain lie. It also claims that “[there is no] clear biological mechanism for putative adverse health effects of fluoridation...”, which would surprise the authors of a recent Lancet Neurology article.

All in all, this report isn’t worth the paper it’s written on, or even the bandwidth it’s transmitted on. Whether it heralds a concerted push by the UK government to artificially medicate the population with fluoride remains to be seen. If it does, the resistance will be both mighty and mightily well informed – seemingly unlike PHE.