Alex White (Dublin South, Labour) | Oireachtas source

I thank the Deputy for raising this serious issue which I am pleased to have the opportunity to address. I will respond to some of the specific points raised by the Deputy, but I remind the House by way of introduction that water fluoridation and the use of appropriate fluorides are major planks of public health policy in Ireland on the prevention and management of tooth decay. Fluoride at the optimal level in the water supply provides a constant repair kit for teeth, making them more resistant to decay in people of all ages.

Fluoridation began in Ireland in 1964 on foot of the Health (Fluoridation of Water Supplies) Act 1960. Local authorities act as agents for the health authorities in fluoridating the water supply. The forum on fluoridation published a report in 2002 following its major expert review of the policy of fluoridation. Its main conclusions were that the fluoridation of public piped water supplies should continue as a public health measure, that the optimal level of fluoride in water should be reduced to between 0.6 and 0.8 parts per million and that an expert body on fluorides and health should be established. The main function of the expert body on fluorides and health is to provide impartial and evidence-based advice for the Minister and evaluate ongoing research on all aspects of fluoride. I emphasise that the expert body considers only scientific evidence that has been peer reviewed and approved for publication in recognised scientific journals. That is the standard approach where scientific evidence is required to underpin public policy on health. Having studied current peer reviewed scientific evidence internationally, the expert body is satisfied that water fluoridation at the optimal level does not cause ill effects and continues to be safe and effective in improving oral health in all age groups. This view is supported by reputable international agencies and valid scientific articles and reviews.

I am aware that some consumers express concerns about potential negative effects on health of drinking fluoridated water, the composition and source of fluoride and the fact that other countries do not fluoridate their water supplies. All of the evidence is that drinking fluoridated water with optimal levels of fluoride is not harmful to human health. I emphasise that the only known side effect of optimal water fluoridation is mild dental fluorosis which is not considered to be an adverse health effect. Fluoride is added to our water supplies in the form of hydrofluosilicic acid which is in compliance with the specifications for that substance set out in the 2007 regulations. The procedures to fluoridate water supplies to the prescribed standards and minimise the risk of injury or damage to plant, personnel and the environment are set out in a code of practice. Water to which fluoride is added is tested daily by the local authorities and monthly by the HSE and the Environmental Protection Agency. As an alternative to water fluoridation, other countries have chosen salt or milk fluoridation or to invest in large-scale public dental services. Surveys of child and adult oral health conducted to date show a substantial benefit through the reduction of the experience of tooth decay. Irish children and adolescents have a high frequency consumption of sweets and confectionary, as well as generally poor tooth brushing habits compared to their European counterparts. Accordingly, the use of fluoridated toothpastes alone is insufficient to prevent toot decay.

I accept that this is a serious issue and that people are entitled to raise the matter for debate both here and in the Upper House. I am not a scientist and cannot make a scientific judgment on the basis of any knowledge that I possess. The Deputy is an expert on many things, but I do not think he is a scientist either. As legislators, we must rely on independent evidence examined by the expert body put in place to do this work. While I have no difficulty with matters of public concern being raised, the preponderance of the evidence is in favour of the continuation of this policy. The Deputy will see this, if he looks closely, as I have, at the evidence and material available from the expert body. Studies are occasionally produced which tend to push one in the other direction if one reads only these studies. However, when one has to balance the concern and responsibility for public health which we have not only in government but as Members of the Houses of the Oireachtas generally, it behoves us to examine in a reasonable, balanced way not just one study but the preponderance of the evidence and its import. I invite the Deputy or any other Member to look at the website of the expert group and examine the evidence set out on it. The evidence has been peer reviewed and is not drawn from one source or campaign. It is there for all to see and annotated. I have looked at the evidence, as has the Department, as it is required to do. It is not looked at once but is kept under constant review in the implementation of the policy. When one sits down and considers the material, it is clear where the preponderance of the evidence lies.

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