Fluoridation of water is a cheap, effective and harmless mechanism for combating tooth decay. It’s pumped into the general water supply. Tooth decay is rarely life threatening but can be painful and disfiguring. The argument goes that as there is a known, risk free, technique for mitigating tooth decay it should be used. Water supply in Britain is regulated and since the 1850s, when cholera was identified as a water borne disease, tap water has been safe in the usual way of things. Recently, those advocating fluoridated water have employed public health arguments to promote their cause for additional regulation of the water supply. In summary, where there is preventable harm there is a demand for government intervention.
Public health arguments are very clear. Public health demands government intervention when there is an unavoidable risk to health resulting in death or significant harm. Regulating water supply is a paradigm for government action. Mid-nineteenth century London suffered a series of cholera outbreaks. Dr John Snow did a statistical analysis of one outbreak in Soho and demonstrated that a single water pump was responsible. Once Snow showed that cholera was a water borne disease the public health argument demanded action. Cholera is an unavoidable potentially lethal disease if there isn’t regulation ensuring clean water.
Fluoridated water isn’t in the same category, as tooth decay is highly unlikely to be lethal. British children and their parents can easily use strategies to avoid tooth decay. Yet tens of thousands of children suffer very real harm. 2013-4 saw 260,000 children subject to hospitalisation to have teeth removed under anaesthetics. It could be said that children who suffer serious tooth decay are victims of their parents and the British way-of-life.
British diets are sugar saturated. The public health argument for fluoridated water implicitly claims that British society is toxic. Simply living in Britain is to be subject to a poisonous environment of food, food preparation and drink that are legally available and known hazards. The ubiquity of these foods and drink is such that they are quasi-unavoidable. Harmful drinks, for example, are widely advertised and sold nationwide by multi-million pound industries. These drinks are attractive to consumers and especially the young. Whether parents are irresponsible, uneducated or wilful is irrelevant. If a public health argument is legitimate then it is the government’s duty to act.
The call to action is obvious. Unfortunately it’s a potent argument for further government interventions in diet, which may be less welcome. A quarter of a million children being hospitalised with rotting teeth is one thing but millions are suffering from obesity. The list of diseases linked to obesity is long and impressively dangerous; tooth decay is a triviality in comparison. The principal diseases linked to obesity are:
High blood pressure
Diabetes (Type 2)
Breathing problems including sleep apnea (when breathing stops altogether for short periods) Asthma
Cancer of the breast and bowel*
If there is any plausibility in the public health argument for fluoridated water then there is also a compelling case for government intervention in the national diet. Lethal diets are wrecking the health of millions of British people. Government intervention proactively attempting to counter obesity would intrusively interfere in the British diet. Even the British government could reasonably expect a very hostile response to proactive interference with the people’s diet.
The management of the entire population’s health by direction isn’t feasible in Britain. Fluoridated water interferes in choice where choice appears non-existent. Tooth decay and obesity are, in general, avoidable. It isn’t the job of a British government to prevent preventable harm for the entire population unless the harm is an unavoidable consequence of living in Britain.
*See the information from the NHS http://www.nhs.uk/Conditions/Obesity/Pages/Introduction.aspx