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Fluoridation of some public water supplies in Ireland may have to stop until plants and technology are upgraded to properly control the amounts of fluoride added. The Government's Fluoridation Forum has also called for a one-third reduction in the amount of fluoride added in all existing fluoridated supplies.
It says of the 74% of the population involuntarily compulsorily connected to fluoridated water supplies: "If the State were concerned about real choice, then consideration would have to be given to supplying an alternative source of water."
The Forum concluded, however, that fluoridation has been "very effective" in reducing tooth decay in Ireland and it says the policy of adding fluoride should continue. While it notes an increase in dental fluorosis (staining of teeth due to excess fluoride), it says this is primarily due to excessive use of fluoride toothpaste by children.
It has called for a range of measures to prevent inappropriate use of toothpaste and other fluoride products among youngsters including educating parents that children under two should not use fluoride toothpaste and that those aged two to seven year olds should use only a pea-sized amount.
The Forum, which received over 1,000 submissions from members of the public, spent the last two years reviewing the State's fluoridation policy. Its key recommendations are:
Amount of added fluoride in water should be reduced from one part per million to between 0.6 and 0.8 of a part per million.
Products containing fluoride to be better labelled and carry clearer instructions for use.
Child-proof containers to be used for mouth rinses and certain other products containing fluoride.
Research into fluoride to continue and be expanded and properly funded.
Regional public meetings to be held to address public questions and concerns about fluoridation.
Better measuring and ongoing monitoring of fluoride levels in water with external audits of fluoridation plants.
The Forum says technical problems in some smaller water treatment plants are giving rise to difficulties in maintaining the optimum level of fluoride. "To avoid the risk of over-exposure, it may be necessary to suspend fluoridation of some small public water supplies," it concludes.
The report was welcomed by Minister for Health, Micheál Martin, who said it provided detailed, scientific support for the continued use of fluoride in water supplies. He acknowledged it was an issue that "created strong feelings" but said fluoridation was essential in a country which was among the world's top three consumers of sweets.
The environmental group VOICE (Voice of Irish Concern for the Environment) criticised the Forum's findings, however, and accused it of displaying a "State knows best" attitude. It said people had the right to make up their own minds whether or not they wished to consume fluoride.
Disability rights campaigner Kathy Sinnott said children with autism and related bowel problems, and other people with certain medical conditions, were particularly vulnerable to chemicals in water and should not have to consume fluoridated supplies.
She called for the existing State grant for installation of a water supply in houses without an existing or acceptable supply should be extended to all households who wished to provide themselves with an alternative supply.