ALMOST HALF of populations living in fluoridated areas have dental fluorosis ('tooth mottling') - a disease caused by excess exposure to fluoride. Scientists worldwide recognise this as "the first visible sign of fluoride poisoning." Nevertheless, the British Public Health Minister believes that the recent NHS review on water fluoridation, commissioned by the Department of Health, provides the basis for recommending water fluoridation. Says Minister Yvette Cooper: "We will be encouraging health authorities with high levels of dental decay to consider fluoridating their water as part of their overall oral health strategy."*

In 1994, the World Health Organisation warned: "Dental and public health administrators should be aware of the total fluoride exposure in the populations before introducing any additional fluoride programme for caries prevention." (Fluorides and Oral Health, WHO, Geneva.). International scientists invited to peer review the York study have severely criticised the protocol and narrow criteria for this review**. They were particularly critical of the failure of the review to take into account total fluoride exposure from a wide variety of sources. The Government's White Paper stated that the NHS Centre for Reviews and Dissemination at York University would determine the effects of fluoride on HEALTH. However, the York review considered fluoride exposure from drinking water alone. Furthermore, it SPECIFICALLY EXCLUDED all animal studies, all biochemical studies and all mathematical models - and exposure from any source other than water. The favourite British beverage - tea - contains very high levels of fluoride. Studies on tea submitted to York were excluded from consideration, along with many thousands of other published papers.

Of less than 300 studies accepted for inclusion, NONE reached the highest quality (Level A). The vast majority were graded as Level C - "poor quality with a risk of bias."

Based on these poor studies, the reviewers found a reduction in tooth decay of only 14.6% (not the 50% - 60% formerly claimed by pro-fluoride lobby) AND that almost 1 in 2 (48%) of those living in fluoridated areas have some degree of dental fluorosis - people who could not avoid the risk. Moreover, the review found that 1 in 8 (12.5%) of people living in those areas display moderate to severe dental fluorosis.

In a written answer to Lord Baldwin in April 1999, The Baroness Hayman responded for the government that dental fluorosis is:

"a manifestation of systemic toxicity" - bodily poisoning. This concurs with scientific opinion worldwide. However, using carefully chosen language, the York review described moderate to severe dental fluorosis as "aesthetically concerning", thereby minimising the important, visible clinical signs of fluoride poisoning.

Because of its deliberate omissions, exclusions and serious errors***, the so-called "systematic review" conducted by the NHS Centre for Reviews and Dissemination provides no basis for any government policy in favour of fluoridation. The National Pure Water Association strengthens it call for a full independent public inquiry into water fluoridation and the protocol and conduct of the government's "systematic review".

To ask the Secretary of State for Health what plans he has to extend fluoridation of drinking water; and if he will make a statement. [134359]

We will be discussing the systematic review of water fluoridation produced by the University of York with representatives of the water industry. We will also be encouraging health authorities with high levels of dental decay to consider fluoridating their water as part of their overall oral health strategy. The report of the evidence review will help ensure that local decisions are based on an authoritative, readily accessible summary of research into the safety and efficacy of water fluoridation.