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Draft NHMRC Information Paper: Effects of water fluoridation on dental and other health outcomes submission

ID: 
14
This submission reflects the views of
Organisation Name: 
British Fluoridation Society
Personal Details
Specific Questions
Q1. A) Is the draft Information Paper presented in a manner that is easy to understand? : 
Agree
Q1. B) Please provide details regarding your response to Question 1A: 
Q2. A) Is it clear how NHMRC reviewed the health and dental effects of water fluoridation? : 
Agree
Q3. A) Is the Fluoride Reference Group’s interpretation of the evidence clearly described in the draft Information Paper?: 
Agree
Q4. Is there additional evidence on the dental effects of water fluoridation that should be considered?: 

Dental effects. In your inclusion criteria you require ecological and cross-sectional studies to have included relevant confounding factors in the analysis. We support that decision, but point out that one of the studies you cite (Rugg-Gunn and Do, 2012) noted that “Overall, there was no great change in the percent caries reduction after adjustment (for confounders) compared with before adjustment”. Perhaps this could be mentioned in the text.

Q5. Is there additional evidence on any other health effects of water fluoridation that should be considered in the draft Information Paper?: 

Other health effects. You review papers on general health effects from 2006 through to 2014 although this period is extended to 2015 for dental effects. We entirely understand how this can arise, but suspect that anti-fluoridation campaigners in the UK will claim that this was a deliberate ploy to avoid a paper published in February 2015 by Peckham; Journal of Epidemiology and Community Health 69, 619-623. This paper has been widely criticised not least by Public Health England (J N Newton et al 2015 Journal of Epidemiology and Community Health 69,617-618). Again perhaps a passing reference could be made to these papers.

Q6. Is there any other supporting material relevant to making decisions on water fluoridation in the Australian context that should be considered in the draft Information Paper?: 

Ethics Again we welcome this innovative section. We tried to deal with this in our own publication “One in a Million” the third edition of which is available on our website. We identified three reports that may be of relevance to Australia. The first was by Lord Avebury (Fluoridation and individual freedom. British Dental Journal 1984 166, 277). Lord Avebury was a UK parliamentarian, and founder and chair of the Parliamentary All-party Human Rights Group. Secondly we identified a number of relevant reports from the Irish Supreme Court and from the Irish Expert Body. The third was a detailed report by the Nuffield Council on Bioethics (2007) (Public health and ethical issues. Nuffield, London) which laid out in detail some general principles and then a series of case studies including a chapter devoted to water fluoridation.

Page reviewed: 4 July, 2017