Q1: How strong is the scientific evidence that fluoride in water supplies is a cause of adverse health effects? What are the proven and suggested health risks? How strong is the evidence for each?
There are a number of recent studies have confirmed that water fluoridation can reduce the prevalence and incidence of dental caries among children in the majority of fluoridated areas (Armfield, 2005; Jones, Burt, Petersen & Lennon, 2005). More specifically, recent Australian research has demonstrated that the prevalence of tooth decay has significantly decreased through community water fluoridation since the mid-1990s (Victorian Government Department of Human Services, 2009). When fluoride is used in an optimal level, it is effective in preventing and controlling dental caries. Conversely, consumption of excessive fluoride during the teeth formation period can cause dental fluorosis.
As reported by Australian Government National Health and Medical Research Council (2007) that the regular consumption of high fluoride concentrations water (above 1.5 mg/L) can gradually increasing the risks of developing skeletal fluorosis, thus resulting in brittle bones. In addition, skeletal fluorosis can result in bone pain and joint stiffness may occur in areas with high levels of fluoride in the water. It is stated that water fluoridation is associated with an increase of 13 precent in the risk of unaesthetic dental fluorosis (Australian Government National Health and Medical Research Council, 2004; McDonagh et al.,2000).
The suggested health risks are included bone cancer, hip fractures, allergic reactions, kidney disease, arthritis and other health conditions (Victorian Government Department of Human Services, 2007b). According to Centres for Disease Control and Prevention (1999), the safety and effectiveness of water fluoridation have been re-evaluated frequently, and there is no credible scientific evidence supports an association between fluoridation and any of the above suggested health risks (McDonagh et al., 2000; Demos et al., 2001). In addition, studies done by Kim et at., (2011) and National Research Council (1993) have also shown that there is no association between fluoridated water and cancer.
Based on the above finding, it is evident that water fluoridation protects against tooth decay without causing any unwanted effects apart from skeletal and dental fluorosis.
Q2: What are the possible sources of human exposure to fluoride? (Consider all possible sources) How could the level of exposure to fluoride be assessed for: a) the population as a whole? b) children in particular?
The following are the main sources of general population exposure to fluoride determined by National Health and Medical Research Council (2007): a)
There are small amount of fluoride in the air. It is more likely to inhale higher levels of fluoride in areas that are located close to coal-fired power plant, hazardous waste sites, or any fluoride-related industries. b)
Direct water consumption through tap or any beverages that is prepared with fluoridated water. c)
Direct contact with soils that contains high level of fluoride mineral deposits, especially where coal-fired power plants or fluoride-releasing industries are built. d)
Foods that grown in areas where fluoride-containing soils or phosphate fertilizers are used have been found to have higher levels of fluorides. Besides that, tea and certain seafood also contains high level of fluoride. e)
Sodium fluoride is added to toothpaste and mouth rinses in order to prevent dental cavities. f)
Those who work in fluoride-containing industries have higher risk of breathing in fluoride-containing dust. g)
Environment: natural & anthropogenic
This include volcanic emissions and coal combustion industry The possible sources of fluoride as mentioned above are illustrated in appendix 1.
Young children have...
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