Fluoridation of public water supplies as a public health measure is accepted as being one of the most effective methods of ensuring against tooth decay. The World Health Organisation (WHO) recommends fluoridation of public water supplies and has stated that "fluoridation of water supplies, where possible, is the most effective public health measure for the prevention of dental decay." The WHO has also stated that "people of all ages, including the elderly, benefit from community water fluoridation".
The recently completed survey of oral health, covering the whole island of Ireland, shows that fluoridation of public water supplies continues to be a highly effective public health measure. It has contributed significantly to a major reduction in the incidence of dental decay in the Republic of Ireland. This compares favourably with the incidence of dental decay in Northern Ireland, which has significantly higher rates of dental decay and which does not have fluoridated water supplies. The oral health survey examined numerous aspects of fluoridation including dental fluorosis.
The oral health survey also shows that fluoridation of public water supplies has a significant impact on dental decay in disadvantaged areas. The gap, in terms of levels of decay, between non-disadvantaged and disadvantaged areas in the Republic of Ireland is significantly less than the gap between such areas in Northern Ireland.
The research carried out shows that, at the levels of usage of fluoride in the Republic of Ireland's public water supply, there is no risk to health. Fluoridation of the water supply in Ireland is limited to a maximum of one part per million. In this regard, the WHO and the European Union have identified that fluoridation levels below 1.5 parts per million are acceptable.
The Forum on Fluoridation recognised that there has been some increase in the incidence of mild dental fluorosis in Ireland. Most dental fluorosis is only detectable by dentists. The Forum, while recommending that fluoridation of water supplies continue, recommended a reduction in the levels of fluoride used from between 0.8 parts per million and 1 part per million to between 0.6 parts per million and 0.8 parts per million.
The Irish Expert Body on Fluorides and Health was set up in 2004. The terms of reference for the Expert Body are: — to oversee the implementation of the recommendations of the Forum on Fluoridation; — to advise the Minister and evaluate ongoing research — including new emerging issues — on all aspects of fluoride and its delivery methods as an established health technology and as required; — to report to the Minister on matters of concern at his/her request or on its own initiative.
As part of its work in implementing the recommendations of the Forum, the Expert Body examined the question as to what amendments may be required to the regulations, under the Health (Fluoridation of Water Supplies) Act, 1960, in order to give effect to the Forum's recommendation to reduce the level of fluorides in the public water supplies. The Expert Body has reported its findings to my Department. My Department is currently taking the necessary steps to introduce a new Regulation.
The results of fluoridation research and proposals for any future research is a matter for consideration by the Irish Expert Body on Fluorides and Health.
