Brian Rudman is a NZ Herald feature writer and columnist.

Brian Rudman: Sweet move on fluoride - now for sugar

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Minister hypocritical in use of experts.
Illustration / Peter Bromhead
Illustration / Peter Bromhead

It's hard to keep up with Health Minister Jonathan Coleman. Last week I was berating him for rejecting the World Health Organisation's demand for a sugar tax to help fight the obesity epidemic.

This call was backed by the Prime Minister's chief scientific adviser, Sir Peter Gluckman.

But now the minister has turned around and invoked both Sir Peter and WHO to help bolster his proposal to shift the decision-making on the fluoridation of drinking water from local government politicians to the district health boards. He says the DHBs "will be far more motivated to put fluoride in water".

I hasten to congratulate Dr Coleman. For decades, generations of New Zealanders have suffered the agonies of unnecessary tooth decay because politicians, both national and local, have run scared of the unscientific mumbo jumbo of a few anti-fluoride scaremongers.

Even today, 40 of the country's 67 local authorities refuse to add the decay-preventing mineral to their public drinking supply, leaving 1.4 million New Zealanders, in particular the young, vulnerable to an increased risk of pain and tooth loss.

As Dr Coleman said: "New Zealand has high rates of preventable tooth decay and increasing access to fluoridated water will improve oral health, and mean fewer costly trips to the dentist for more New Zealanders."

The irony is that to back a move that decades of his predecessors have been too spineless to implement, the good doctor has embraced not only Sir Peter, but also the WHO. He noted that Sir Peter, the Royal Society of New Zealand and a panel of experts had, in 2014, concluded "there is compelling evidence" that fluoridation "produces broad benefits for the dental health of New Zealanders".

So why, you have to wonder, does he turn his back on these very same experts when it comes to their advice on a sugar tax, preferring instead to follow the self-interested clamour of the fizzy drink manufacturers and the grocery trade lobbyists?

Dr Coleman tells us that in 2013, 40 per cent of all 5-year-olds had already experienced tooth decay, with 35,000 kids between 1 and 4 years having had a decaying tooth extracted that year. He said fluoridating water would reduce tooth decay in children by 40 per cent.

But not, he fails to add, if they keep guzzling bottles of sugar-laden drinks.

You only have to pick up the latest WHO guidelines on sugar intake to learn that fluoride, for all its merits, is no match for the high sugar intake of modern diets. This sugar mixes with bacteria in the mouth to create acids which eat away at the tooth enamel leading to cavities. Fluoride can delay the process, says WHO, but not prevent it.

Still, taking the decision-making of this important public health issue out of the hands of politicians, both local and national, is long overdue. In Auckland, for instance, it will hopefully end the odd anomaly where the citizens living in the boundaries of the long-gone Onehunga Borough drink unfluoridated water, while their neighbours in the rest of the Super City enjoy treated water.

Onehunga has historically drawn its water from local springs and in 2001, following an earlier round of amalgamation that brought Onehunga and the other isthmus councils into an enlarged Auckland City, a "referendum" on whether to fluoridate Onehunga water was conducted. Only a third of ballot papers were returned, with 62 per cent against change. Despite the local community board bravely voting for change, the full council voted 10 to 9 to retain the status quo.

Up and down the country the issue bubbles, as local fanatics pop up to litigate their anti-science. Credit for kicking off the latest decision goes to former Auckland Council chief planning officer Roger Blakeley who, in February 2014, wrote to Sir Peter, the Royal Society and Ministry of Health asking for a review of the scientific evidence.

This was followed up in July that year, with delegates to Local Government New Zealand's annual conference voting strongly to have this "public health issue" taken over by national health authorities. The Gluckman-Royal Society report followed soon after with the expert advice Dr Coleman has embraced.

Shame about the sugar.

Debate on this article is now closed.

- NZ Herald

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Brian Rudman is a NZ Herald feature writer and columnist.

Brian Rudman's first news story was for Auckland University student paper Outspoke, exposing an SIS spy on campus during the heady days of the Vietnam War. It resulted in a Commission of Inquiry and an award for student journalist of the year. A stint editing the Labour Party's start-up Auckland newspaper NZ Statesman followed. Rudman decided journalism was the career for him, but the NZ Herald and Auckland Star thought otherwise when he came job-hunting. After a year on the "hippy trail" overland to London, he spent four years on Fleet St with various British provincial papers. He then joined the Auckland Star, winning the Dulux Journalist of the Year award for coverage of the 1976 Dawn Raids against Polynesian overstayers. He has also worked on the NZ Listener, Auckland Sun, and since 1996, for the NZ Herald as feature writer and columnist. He has a BA in History and Politics.

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