Dear All,

I have been so preoccupied with preparations for the FAN conference which starts today and our efforts to stop the use of sulfury fluoride (deadline for comments August 4) that I have tended to neglect some of the news from other countries. Here, however are two articles from Australia. First, is news that the Ballina council has voted (6 to 3) to rescind a previous motion to fluoridate their water. Congratulations to the citizens who persuaded their officials to change their minds on this issue.

The second article comes from the Sydney Morning Herald. The article titled “Nation in decay” is the kind of article that is often used to promote fluoridation - however in this case that is a little difficult since NSW is already 90% fluoridated!

Those interviewed blame the increase in tooth decay on long waiting lists for care, “diets that are high in sugar” and the increased use of bottled water. However, as far as the latter point is concerned, not mentioned in this article is the argument from spokesperson from the Bottled Water manufacturers who says that this is unlikely because tooth decay is most prominent in families with low income and this is not where most of the bottled water is consumed. Nor does the article mention a study from South Australia by Armfield and Spencer (2003) who found no difference in tooth decay in the permanent teeth between those children who had drunk bottled or rain water all their lives and those who had drunk fluoridated water.

At least one of the commentators admits (unlike most promoters of fluoridation) that “People seem to see fluoride as a panacea, but it isn’t.”

It is interesting that major newspapers in Australia give so much attention to articles on teeth and fluoride but very little to the serious health concerns caused by over-exposure to fluoride. There has been little commentary in Australian papers on the Harvard study on osteosarcoma and even less on the 450 page 3-year review by the National Research Council, published in March of this year. Despite these awful omissions one of those interviewed in this article proclaimed that: “The mouth should be given the same status as the rest of the body.”

In my view, it is precisely this gospel of public health dentistry which has distorted and corrupted the debate on fluoridation for over 50 years. The teeth are important but not moreso than the bones, the brain, the thyroid gland and other tissues. Nor more important than the possibility that some young boy’s lives may be ended in their teens because of fluoride caused osteosarcoma.

Is it too much for the Australian printed media to actually examine these questions? Or are they only going to be treated to the minutia of teeth, teeth, teeth and teeth?

Meanwhile, hats off to those citizens who are prepared to do their homework and put pressure on decision makers to resist this irresponsible practice.

Please don’t forget to send in your ONLINE letter to Stephen Johnson before the August 4 deadline for comments in opposition to huge increases in fluoride levels in our food. It is is easy, quick and very important. Please go to http://actionstudio.org/?go=2367 and get your friends to do the same.

As of 8:00 am (EST) 1914 letters have been sent. More details later today.

Paul Connett

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NORTHERN STAR

http://www.northernstar.com.au/localnews/storydisplay.cfm?storyid=3694310&thesection=localnews&thesubsection=&thesecondsubsection=

Ballina backflip on fluoridation

28.07.2006

By MARY MANN

mary.mann@northernstar.com.au

BALLINA Shire’s water supply will stay unfluoridated.

At yesterday’s meeting, six councillors voted in favour of the rescission motion to overturn council’s last vote endorsing fluoridation, with only three voting against the motion.

Councillors Johnson, Wright, Felsch, Howes, Rich and Brown supported the motion, while councillors Silver, Cadwallader and Moore opposed it.

Cr John Felsch said he felt refreshed that the anti-fluoride lobby had won.

“I applaud the dedication of those who supported it,” he said.

Cr Felsch, along with Crs Howes and Wright, put his name to the motion to overturn the council’s last vote endorsing fluoridation.

“Today is a bit of a milestone in the history of our local government,” Cr Felsch said.

“I sat here about 12 or 15 years ago when we debated it and eight out of nine councillors dumped water fluoridation.

“And I’m sure it will be back at this table again in about two-and-a-half years.”

Cr Moore, who voted against the motion, said there were more reasons for fluoridating the water supply than there were against it.

“We have people saying there are other choices…but there are kids who don’t go to school because their teeth are so sore and we see a flow-on of social disadvantage because of this,” he said.

“It is clearly in the public interest to support water fluoridation.”

Mayor Phil Silver applauded Rous Water’s policy of fluoridating the water of only those councils who wished to be fluoridated.

“I can’t think of a more logical, proper position for them to take,” he said.

Cr Silver said he favoured the right of children to have good dental health over the right of people not to ingest fluoride if they didn’t want to; thus didn’t support the motion.

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July 27, 2006

Emily Dunn

The high costs of dentistry and a shortage of practitioners are putting the bite on Australians.

It starts as a tiny fissure that slowly grows to a black cavity. It attacks soft tissue and bone, causing painful swelling and bleeding. Left untreated it can develop into full-blown cellulitis and you can end up in hospital, with a hefty medical bill to boot.

It is the most common medical condition in Australia and it isn’t diabetes or heart disease. It’s tooth decay, followed closely by its related condition, gum disease.

Dental diseases are also among the most preventable health conditions.

Australians are visiting dentists more often - two-thirds of us now see a dentist regularly, up from 50 per cent a decade ago - yet, according to the Australian Council of Social Service, the oral health of middle-aged Australians is among the worst in the developed world, with tooth decay on the rise.

Australian children enjoy one of the best standards of oral care in the world. However, a report released last week by the Australian Research Centre for Population Oral Health at the University of Adelaide shows the number of children requiring general anaesthetic for dental surgery, most commonly tooth extractions, tripled in the past decade.

Each year more than 30,000 people in Australia are hospitalised because of a dental condition, usually a tooth or gum infection that has been left to fester. So why the neglect for our teeth and gums?

Dentists say a lack of funding and a lack of dentists are just two of the reasons. “Governments treat dentistry as if it is not part of health, as if the human body stops at the mouth,” says Hans Zoellner, chairman of the Association for the Promotion of Oral Health. “The mouth is a communication organ, a sexual organ and it is cosmetic - it is not just for eating.”

A report published last week in the Medical Journal of Australia predicted that by 2010 Australia will be short 1500 dental care providers. Zoellner says almost a third of the vacant positions will be in NSW.

For those in poor socio-economic or regional areas, the issue of access to dental care is more critical. There are about 9000 practising dentists in Australia, about 43 per 100,000 of population, but in rural areas this ratio drops to 28.

The second and perhaps most prohibitive factor for patients is the cost of a visit to the dentist.

There is no Medicare rebate for dental care. In 1997 the Liberal Government axed the Commonwealth Dental Health Program, designed to lower waiting lists in the public system.

Publicly funded dental care is now provided through the state hospital system but it is restricted to children aged up to 18 years and concession card holders (about 34 per cent of the adultpopulation).

In NSW there are only about 240 dentists working in the public system, compared with more than 3000 private practitioners, and the teeth they see are often in an advanced state of decay.

Population Oral Health research shows public patients are twice as likely as private patients to have teeth extracted.

Last year, an investigation by the Herald found patients in the public system were waiting up to eight years for treatment. That led to an NSW parliamentary inquiry, which found NSW spent less than any other state on dental health.

In response, the NSW Government announced that an extra $40million would be spent on dental health in the next four years. The funding will be used to reduce waiting lists in the public systemand target groups at risk of dental problems, including young children and senior citizens.

Zoellner says the additional funding is not enough to improve waiting list times and staffing levels in NSW. “[The funding] willbarely meet the inflation rate.”

With about 250,000 public patients in NSW on waiting lists for dental treatment, patients are seeking help from general practitioners and, in some cases, requiring hospitalisation fordental infections.

“GPs are seeing an endless stream of patients coming in forrepeated scripts of antibiotics and painkillers for teethproblems,” Zoellner says. “This is at a substantial cost to thepublic purse.”

But while those in the public system deal with long waiting lists, patients in the private system have the burden of highcosts.

About 85 per cent of dentistry is performed in the private sector. The Australian Dental Association does not recommend a fee schedule for its members but, according to the MJA report, practitioners charge an average rate of $350 an hour, of whichoverheads account for about 70 per cent.

The president of the ADA, Chris Wilson, says fees vary alongwith the rebate from health funds, with some funds only paying fortreatment from preferred providers. “The decision whether or not to have a treatment comes back to the patient,” Wilson says. “The dentist informs them of the risks and the cost.”

For those without private health care, the cost can be too much.

The report in the MJA estimated 25 per cent of dental patients delay treatment because of the cost. The likes of root canal surgery can cost upwards of $500 at a private practice; surgical procedures can add thousands of dollars.

Delayed treatment means that problems get worse and the eventual treatment becomes more expensive.

Delaying the inevitable through the use of antibiotics is also a problem. “This creates a public health issue - the over-use of antibiotics creates strains of resistant bacteria,” Zoellner says.

“From a public health perspective, it is lunacy that there is not guaranteed treatment for acute infection, that people are waiting.”

The majority of dental problems are largely preventable. However, the problems dentists are treating are increasingly complex. This is due in part to delayed treatment but also, ironically, to an improvement in oral health since the introduction of fluoride in the 1950s.

Fluoridated water supplies, along with fluoridated toothpaste and mouthwash, has meant people are keeping their teeth longer.

Tony Dawson, a Canberra prosthodontist specialising in reconstructive and replacement dentistry, says that while edentulism (people who are completely toothless) is decreasing, the number of people who have some teeth missing is increasing.

“We have gone from the ‘when in doubt, pull it out’ phase of dentistry to a much more conservative view,” Dawson says.

The more dental work people have, the more maintenance they may need, such as replacement fillings. “Everything we do has a certain life expectancy - these days we try and do the smallest possible fillings we can,” Dawson says.

Dental work such as fillings are often necessary to prevent further tooth decay, but it takes a toll on teeth. Each time a filling is replaced it takes a part of the tooth with it and, eventually the tooth may need to be replaced.

The trend towards people keeping their teeth for longer also means dentists are treating older patients with associated health complications.

‘When you are younger, the problem is likely to be tooth decay,”says Mark Schifter, a senior specialist in oral health at the University of Sydney. “But when you are older it is gum disease.”

Gum disease is linked to conditions such as diabetes, heart disease and low-birthweight babies. Gum disease that is left untreated has also been shown to worsen a patient’s diabetes.

“Evidence also suggests there is a similar causal relationship between oral health and cardiovascular disease,” Schifter says.

“The worse the gum disease becomes, the worse the medical condition, and vice versa.”

For some, gum disease is unavoidable. Some are genetically predisposed to tooth decay and gum disease - they just have the wrong saliva. “Some salivas have better anti-bacterial properties than others and some [people] have more aggressive bacteria,”Schifter says.

“We need to identify these patients that need help before the problems get out of control.”

Pregnant women are at higher risk of gum disease and, if thecondition develops, they risk delivering lower birth-weight babies because of the toxins produced by the bacteria entering the bloodstream.

Mothers also risk passing on the bacteria to their babies. When babies are born, their mouths are sterile. It is only when they begin sharing food and utensils, usually with their mother, that bacteria starts to build up in their mouths.

“If you are planning to have a baby you should visit your doctor and your dentist,” Schifter says.

Advances in fluoridation, now present in 90 per cent of the NSW water supply, are also being offset by diets that are high in sugar.

As a result, the rate of caries, or holes, in children’s teeth is increasing.

“People seem to see fluoride as a panacea, but it isn’t,” Schifter says.

During Dental Health Week, from August 1 to 7, the ADA will be campaigning for better awareness of how the consumption of bottled water - which does not contain the same amount of fluoride as tapwater - along with sugary soft and sports drinks, is contributing to a decline in dental health.

In addition to government funding, Schifter believes, there should be more public education campaigns encouraging oral health, and they should be given the same status as the campaigns that encourage people to use sunscreen or quit smoking.

“The mouth should be given the same status as the rest of the body,” he says.