Editorial: Fluoridation common sense

"Did you brush your teeth?" must be the question that I have asked most during life, repeating these five words every single day at least twice a day.

Like eating your greens and getting enough sleep, brushing your teeth is one of the key health habits which I - and I am sure many parents - try to instil in their children.

Wouldn't it be great if they listened? But kids can have a tendency to want to stay up all hours; to treat sprouts with all the enthusiasm as a root canal; and despite the threat of said canal, sometimes - shock horror - they sneak off to bed without brushing their teeth.

Which is a worry as removing bacteria regularly from your mouth not only cleans teeth, but the whole gum.

If you don't clean your teeth regularly, you don't just face the prospect of a smile resembling Steve Buscemi in Fargo after he received a bullet to the jaw. Or breath like Chapel St on a hot day.

Poor gum health leads to a whole other host of health issues. Poor teeth cost a fortune to be fixed. Related problems are a burden to the health system. The Ministry of Health says $500 million is spent in New Zealand on dental treatment. The largest proportion of this is treating dental decay which is preventable.

It seems a no brainer then to me to do all that is possible to protect teeth.

Like brushing your teeth with a fluoride toothpaste. Yet, not only might children skip this despite parents' best nagging, some families might have to skip buying it altogether because of cost.

That is why adding fluoride to the water supply is a cost-effective solution that can benefit all regardless of socio-economic situation. As the Ministry of Health points out, "most tooth decay is preventable, and water fluoridation is a simple way to prevent it".

Which is why I am joining the cheers in Whakatane when the Whakatane District Council flip flopped this week and voted to continue adding fluoride to the Whakatane and Ohope water supplies.

The latest move revoked a previous council decision in late January to stop adding it. Thursday's motion, brought by deputy mayor Judy Turner, was supported by a healthy population of the Eastern Bay community who, in 2013, voted to retain fluoride in a non-binding referendum.

Although I do not live in Whakatane and my family cannot benefit, I hope this decision has positive repercussions for Tauranga where we do not currently have fluoride in the water. Fluoride was taken out of Tauranga's water supply in 1992 after a referendum in which more than half of the city's residents voted against its continued use.

It was encouraging that our new Bay of Plenty District Health Board chief executive Helen Mason spoke out this week saying she was disappointed with the original decision by Whakatane District Council to discontinue water fluoridation. The BOPDHB's Principal Dentist Dr Rudi Johnson, said New Zealand's most recent national oral health survey showed that children and adolescents living in fluoridated areas experienced 40 per cent less tooth decay than those living in non-fluoridated areas.

BOPDHB Medical Officer of Health, Dr Neil de Wet added that there was "strong scientific consensus that water fluoridation is safe and effective" and that water fluoridation was supported by both science and the community.

Given this strong support from both the Ministry of Health and the District Health Board, it seems an anomaly that decisions about fluoride are left to local councils rather than central government.

At present, each local government body has its own rules on fluoride which leads to great inconsistency. As bad as toothache, this system can cause financial pain to ratepayers.

Only 23 of the 67 New Zealand councils currently fluoridate their water supplies. The good news is that Associate Health Minister Peter Dunne has acknowledged the current situation is unsatisfactory.

The Government has said it is looking at legislative changes that could make it responsible for decisions around fluoridation.

Many anti-fluoride arguments pivot on the evils of mass medication. However one High Court judgement on the issue in 2014 decided that fluoridation was not medication and was akin to chlorination of water or adding iodine to salt.

There is an argument that it should be be personal choice whether to ingest fluoride, but the children whose parents cannot or do not encourage teeth brushing have no personal choice. Those who really do not want fluoride in their water could buy a filter or bottled water.

I am not a dentist or a health practitioner or scientist.

But I have read the for and against and at the end of the day trust the recommendations by the Ministry of Health, World Health Organisation, Public Health Commission, Ministry of Health and Environmental Science and Research.

While there may be some literature against fluoride in the water, the majority of literature is in favour, and 370 million people in 27 countries have fluoridated water supplies.

Whakatane's decision this week is in my view a victory for science and common sense. Let us hope that it precipitates a move to transfer decisions about adding fluoride to water supplies to the Director-General of Health, rather than local authorities.

I hope the day will come soon when we have fluoride in the water in Tauranga.

It won't stop me asking "Have you brushed your teeth".

But it will stop me gnashing and grinding my teeth at the unfair current situation where what should be a national health directive is decided on the whims of local councils.