Draft NHMRC Public Statement 2017: Water fluoridation and human health in Australia submission

ID:

Personal Details

First Name:

Owen

Last Name:

Allen

Question 1

Q1. A. The draft Public Statement is presented in a format and manner that is useful, and is easy to read and understand:

Agree

Comments on a particular section of the Public Statement:

Question 2

Q2. A. The boxed ‘NHMRC statement’ (page one) in the draft Public Statement is justified and supported by the evidence in the Information Paper: Effects of Water Fluoridation on Dental and Other Human Health Outcomes :

Disagree

Q2. B. If disagree or neutral, please provide recent scientific evidence not previously submitted to NHMRC. Refer to what is ‘Out of scope for this public consultation’ below:

Really a vast host of agricultural (plant nutrition) and human nutrition science; human behavioural science, sociology and public health science, community development science, economic and technological development science, even democratic political science that says this is poorly justified. Maintaining a narrow scope of the idea of fluoridating water as the answer and then asking only the research questions that support that answer is not science. So the justification hasn't been made for public water fluoridation, although the evidence of its efficacy has been made. Fundamentally, the technology is 1950's and, like fossil fuels, sometimes we know we have to abandoned an effective technology because it is not a go-forward for the community and greater efficacies lie elsewhere.

Question 3

Q3. A. For policy makers, the draft Public Statement provides sufficient information to support decision making in your jurisdiction or local area:

Disagree

Overarching/General comments on the Public Statement:

Policy Makers require a more complete advice on the nature and reasons of oral health issues including dental caries. They require an understanding of the full divers array of methods requires to achieve a goal of close to zero childhood caries by, say, 2050. Fluoridation is a minor aspect of that story. A statement recognising the complexity of the causes and methods required - a perspective on fluoridation - would be salutory to the communitieis read of th edocument.

Comments on a particular section of the Public Statement:

Importance of community water fluoridation

There is a mish mash of messages in this paragraph that seem to support each other in a cause effect manner but are not written as that they fully support each other. Unfortunatley there is a paternalism in the attitude of this statement that reads to me like, 'the government should involuntarily medicate poor and low educated people for their own good'. On the other hand it is not clear what actual promises and accountabilities the authors of this document are declaring to those same people, or any of us. If this is a rendition of science, then the apparent cohersions in the argument in this public statement, would not be needed. Although there are 'refusals' written around this feedback survey, it is clear those refusals are because this is a political document pretending it is just a focussed scientific document, not a scientific presentation to the community. In otherwords, if the authors are truly intierested in reducin gth ehours off school, work etc from dental caries, they would have broadened the scope fo this investigation to incude a wider array of technologies and allow the community discussion to open up with enthusiasm for thos goals.

The scientific evidence supporting water fluoridation

The scientific evidence is for some efficacy. Likewise the evidence for 40% of children without caries in non-fluoridated Australian cities sits outside of the research evaluation. Not creating for the Australian community that this makes preventing dental caries very possible without fluoride is a ommisson fromt he full and necessary discussion in community on efficacy of technologies and strategies towards an end game for dental caries and fluoridation. Likewise, efficacy on it's own does not dictate that this is the best strategy moving forward, and, without an end game (is the recommendation for communities to fluoridate water for 1000 years?) it seems there is far from enough evidence to support water fluoridation.

Tooth decay

It is always difficult to marry this statement with the way that the scientific research reads. There is much to be done about the transcription of the research data into a story that can be clearly followed by public leaders and community before I am convinced this is what the research is actually saying. It has an appearance of a 'spin' on the research data. I think the bald statement is unlikely to convince the unconvinceable without more engagement around the questions raised about the efficacy.

Question 4

Q4. How could the Public Statement be effectively disseminated?:

Who would find the draft Public Statement useful?

ANyone who is prepared to accept a statement on face value.

How could they be informed about the draft Public Statement?

Place it as an advertisment in all regional newspapers.

Question 5

Q5. Is there any other information that may be useful to include in the draft Public Statement? If so, please provide details:

A disclaimer that the autheors understand the scientific research around fluoridation of water is mostly out of the ken of the community, that the NHMRC takes responsibility to the community that the proposal they are making in this statement is a promise to lift the dental health rates as defined for every community that fluoridates water, and that the complete preventation of dental caries requires a multi strand apporach including socio-economic improvement, education, and nutrition access.

NHMRC Public Consultations

Draft NHMRC Public Statement 2017: Water fluoridation and human health in Australia submission