Lismore is back on the path to fluoridation as councillors at last night’s marathon meeting overturned last month’s decision to not fluoridate the water supply.
They also voted to hold an urgent workshop to consider the issue in greater depth, which ironically could result in a councillor putting up a further notice of motion to prevent fluoridation.
The fluoride debate attracted a full public gallery and a long list of public speakers on the issue, which included former Lismore City Council (LCC) mayor and councillor Dr Ros Irwin, local GP Dr Sue Page, and state chief medical officer Dr Kerry Chant. Public access and question time went almost two hours before Council began their decision-making process.
Dr Irwin later left the Council Chambers and questioned due process during the public access time as the pro-fluoride presentation by Drs Chant and Page went well over allocated time. In fairness to the joint presentation they were asked numerous questions from councillors, but continuously extended their answers to include further information.
Mayor Dowell repeatedly asked the gallery to respect the rules of Council by not commenting on statements by the pro-fluoride speakers, yet the gallery witnessed many interruptions coming from those same pro-fluoride speakers when they returned to the gallery, at some points providing councillors with supporting information.
Dr Irwin condemned the Murdoch press for misrepresenting those opposing fluoridation.
‘This is offensive to the many thousands of scientists, doctors and dentists and those who have researched the issue for themselves,’ Dr Irwin said.
Dr Irwin told Council that ‘fluoridation has been discontinued from most of Europe and now only eight countries in the world have the majority forcibly drinking fluoridated water’.
Speakers at the meeting said there was a major lack of studies on the systemic results of fluoride ingestion, with most research predominantly focusing only on teeth.
‘This is a concern,’ said Dr Irwin, ‘as fluoride is stored in our bones and steadily increases with age, which makes bones more fragile.’
Dr Irwin cited many peer-researched studies that indicate other areas of harm associated with the process.
Cr Ekins asked Dr Chant if the Department of Health had conducted any epidemiological research into levels of fluoride in blood and bones.
‘I am not aware of any specific studies that have been conducted in relation to blood and bone,’ responded Dr Chant.
Dr Chant went on to discount Dr Irwin’s reference to research on fluoride increasing skeletal fractures.
‘There is no evidence of fluoride at one part per million of increase in bone fractures,’ she said.
Dr Page agreed that claims there is risk to people using renal dialysis machines were not valid.
Both sides use same research
Findings from the same research were used to support and to oppose fluoridation.
A systemic review of public water fluoridation was released in 2000 by the National Health Service (NHS) Centre for Reviews and Dissemination, University of York, United Kingdom.
This was referred to by Dr Chant in her presentation to support water fluoridation, and is what the National Health and Medical Research Council (NHMRC) 2007 guidelines are based on.
NHMRC concluded from this research that ‘fluoridation of drinking water likely increases the proportion of caries-free children by approximately 15 per cent’.
Dr Irwin informed Council that the university’s founding member, Professor Tony Sheldon, ‘had to go public to clarify that the results were widely misrepresented by the British Dental Association, the British Medical Association plus others and those abroad’.
Cr Ekins challenged Dr Chant on the same issue, to which she responded, ‘I am not trying to oversell the 15 per cent benefit from fluoridation, but 15 per cent is very significant’.
Dr Page referred to ten years of research into benefits of fluoridation in the Blue Mountains NSW, which Dr Page said indicated more dramatic declines in tooth decay.
Medical ethics came under scrutiny during the meeting.
Dr Irwin added that ‘it is a violation of medical ethics as it is mass medication with an uncontrolled dose’.
‘I will read directly from Professor Sheldon’s letter… the review did not show water fluoridation to be safe. The quality of the research was too poor to establish with confidence whether or not there were potentially important adverse effects.
‘… the report recommended that more research is needed… until then there will continue to be legitimate scientific controversy.
‘The report also showed there was little evidence to show that water fluoridation has reduced social inequalities in dental health.’
The gallery cheered Dr Irwin, to which mayor Jenny Dowell responded ‘this is not a concert’.
Children’s benefit questioned
Cr Ekins asked Dr Irwin about the background to the pro-fluoridation lobby.
‘I have no doubt that people supporting fluoride do so from of a belief that fluoride actually works. Apart from that I think there are four very important lobby groups behind what is happening now.
‘One is the sugary food industry that benefits from the notion that there is a magic bullet that stops tooth decay whatever sugary food children eat.
‘Two is the phosphate fertiliser industry that sells its waste, which is contaminated with traces of arsenic and heavy metals.
‘Thirdly the aluminium industry, which had an image problem with its atmospheric fluoride solution that it emits from smelters, and which funded some of the questionable early research in naturally fluoridated regions of the USA.
‘Finally some governments consider that fluoridating is a cheaper way of addressing tooth decay than running effective dental services for school children.’
The targeted group for water fluoridation is young children from low socioeconomic backgrounds who would differ individually in how much tap water they consume and if they will receive what is considered optimum dosage.
Mayor Dowell acknowledged the difficulty in instructing the target group to attend to their dental health, admitting the same argument can be applied to the consumption of town water to get optimum doses of fluoride.
‘It is no good instructing a poor family who is struggling to survive,’ said Cr Dowell, ‘with statements like you should be encouraging your children to drink more water, you should be encouraging your child to not drink Coke, you should be teaching your children to brush and floss. It is not going to happen.’
Dr Chant told Council that lower dosages of fluoride (around 0.7 parts per million) would be added to areas where there is higher water consumption.
Regarding dosages she added, ‘in relation to baby formulas, the Australian formulas have been modified to be lower in fluoride to account for the fact that people would use tap water containing fluoride’.
‘Australia is also at the leading edge in promoting toothpaste that is low in fluoride for the early years when children are most likely to ingest it.’
An alternative, more targeted, strategy mentioned by Cr Glenys Ritchie is a process known as fluoride varnishing, where fluoride is topically applied to the individual who needs it. Cr Ritchie referred to the use of this procedure in the Northern Territory and asked Dr Chant if this was considered an option for treating tooth decay in targeted groups.
‘We are exploring fluoride varnishing – there are a couple of trials happening in discrete communities,’ said Dr Chant.
‘Fluoride varnish is seen as more for particular sub-groups in the population rather than valuable and effective on a broader scale.
‘So yes, definitely beneficial, but it’s a targeted strategy that we would put in addition to water fluoridation. It is not an alternative to water fluoridation.’
Dr Page shared how she witnessed poor dental health around 35 years ago when she practised as a GP in Nimbin, compared to what she had seen in Canberra and Sydney, and acknowledged the association with poor dental health and poor dental care.
Cr Ekins asked Dr Page if there was a free dental service in Nimbin.
‘I don’t know whether it is actually located in Nimbin but there is certainly free dental access for them,’ Dr Page answered.
‘At the moment our free dental services have been pretty overloaded.’
Dr Chant said that ‘dental clinics are at the wrong end of the spectrum’.
Dr Page discounted that the area’s high incidence of dental caries, which she quoted as twice the state average, was related to poor access to dental services.
Dr Page challenged the notion that people could be allergic to fluoride.
‘You can’t be allergic to it as it is naturally occurring in the Earth’s crust, so you would be allergic to it walking around on the ground,’ Dr Page said.
Cr Ekins questioned Dr Page about her comments when ‘we are not getting naturally occurring fluoride in our water supply, we are getting a by product from a Chinese factory with contaminants’.
Dr Page ensured that ‘as well as measuring the fluoride we keep a close watch on any of the trace elements. It will be checked and measured before entering the water supply.’
Dr Chant told Council that ‘the issue is that fluoride is not a waste product, it is a co-product because it is naturally occurring.
‘Our water supply is monitored very closely and on a regular basis. We have not had a problem in NSW with the fluoride addition.’
Dr Page added that ‘fluoridated water is quite okay from an organic farming point of view’.
Cr Clough asked Dr Page to respond to the inundation of emails he has received from concerned citizens who have chemical sensitivities, particularly the ingredients in the proposed dosing agent and many who can’t even use fluoride toothpaste.
‘I have also had people tell me that when they go to Sydney they get rashes when they have a shower,’ Dr Page said.
‘When you see how much of NSW is already fluoridated (96 per cent) it is very hard to not be exposed to fluoridated water; you would expect that those people would be having the same issues elsewhere in NSW.
‘I think that people are concerned about this from an emotional and gut reaction type level and we know that the emotions are not always logical.’
The gallery laughed at the comment as the issue is emotional for many, including for pro-fluoride Cr Dowell, who was brought to tears during the debate when she shared her account of moving to the area and bearing witness to the decay in young children’s teeth.
‘If there is one issue that I would stop being mayor for, it is this one and I would hold my head high and my shoulders back. I am passionate about it. I am sorry but you can tell that it is an emotional issue,’ Cr Dowell said.
Shocking images of tooth decay were shown to the gallery by Drs Page and Chant.
‘This is a health issue where you as councillors are trying to make a decision where there is evidence as put out by health professionals that something can be done to reduce these dental impacts on lifelong health in your community.
‘This isn’t a roads and infrastructure issue, this is a health issue.’
Dr Chant addressed Council on the costs of fluoridation in her public access time. The state government have funded the capital costs but Rous Water will pick up the ongoing costs estimated by Rous as $295,000 per annum. According to Dr Chant’s presentation, Lismore will have a 30 per cent share of this, which is $88,500 or approximately $2 per resident per year.
Cr Ekins, who also represents Rous Water, asked Dr Chant ‘was she aware that Rous Water is in over $40 million dollars of debt for the Lismore Source and can’t afford to fix its broken pipes?’
‘So for the health department to tell us we can pay for the fluoride is unreasonable. The $300,000 per anum costs do not include maintenance costs. Look at Richmond Valley; their plant has broken down several times a year for years now. Who will cover that here, we can’t?
‘The Department of Health has been lobbying hard for several years now to fluoridate; if they want it so bad they should pay for it.’
Councillors did vote (Cr Schiebl and Battista against) to request the state government funds the ongoing operating, maintenance and repair costs.
Grouping the opposers of immunisation and fluoride is common in the Murdoch press but had there been further investigation, last month LCC decided to not fluoridate its water supply on the same night they voted to write to the NSW health minister, the minister for the north coast and the Australian minister for health and medical research to show their strong objection of the removal of the free whooping cough vaccinations given to new mothers in the region.
Cr Clough added to the analogy, ‘these situations are very different as vaccinations are undertaken under medical conditions by highly trained medical staff; it is administered as a measured dose to a recipient that is agreeing to it. None of these issues are present in the case of fluoride.’
Dr Chris Ingall also spoke at public access on behalf of a paediatric group and also a broader group of doctors at the Lismore Base Hospital.
‘We have come to regard the situation with our children’s teeth in this region as the norm,’ Dr Ingall said.
‘This is sad. I can pick the people who have grown up in the northern rivers. If I see beautiful teeth I will ask where did you grow up and they will say Sydney.’
Ms Jill Garsden told Council during public access that she was raised on fluoridated water for the first 25 years of her life and was told by a dentist in this area when she arrived here that her teeth wouldn’t last until near her forties.
‘I am happy to report that having lived in this area without fluoride and now being 63 I have great teeth,’ Ms Garsden said.’
Councillors voted unanimously to support Cr Marks’s notice of motion for an urgent workshop to hear from ‘relevant health professionals and scientists’ on both sides of the debate.
Anasuya Claff told Council during public access time ‘she was concerned about who is deciding who is relevant’.
‘There are a number of alternative health practitioners that have looked into this quite deeply and have come up with opposite conclusions from the health minister and the doctors we heard from tonight speaking for fluoride.
‘I suggest that members of the community are also able to speak to the council during the workshop process.’
Cr Graham Meineke failed to persuade fellow councillors (Cr Ekins, Bennett, Smith, Clough, Ritchie, and Houston against) to write to the state government requesting direction regarding fluoridating the LCC water supply.
Cr Clough questioned where LCC would stand if they decided, post workshop, that they did not want fluoridation, and they had sent the letter to the state government.
Dr Chant responded that ‘once you have been directed to fluoridate and you don’t, there are penalties’.
Time ran out for further speakers from the gallery but local herpetologist Richard Wells had an important comment to make.
‘For many years it has been well known by people who keep frogs in captivity, endangered frogs in particular, that you don’t add tap water with fluoride to their enclosures,’ Mr Wells said.
‘They don’t breed as well if at all, and suffer central nervous debilitation.
‘The areas where water comes out from water fluoridation plants are notoriously frog-deficient areas. I’m curious about what studies have been done that relate to the impacts of fluoridation on aquatic ecosystems that receive this contaminated water,’ he said.
Dr Irwin told Echonetdaily that she ‘had never in 17 years of local government seen process go like that.
‘Mayor Dowell was abysmal how she chaired that meeting and no councillor put in a point of order for things like Cr Ekins would ask Dr Page a question then Dr Chant would come over and add her bit as well. It is outrageous,’ Dr Irwin said.
It is believed that conservatively, humans will only consume five per cent of the total fluoridated water supply; the remainder goes downstream.