Fluoridation in Europe

I have been engaged in scientific and political work on water fluoridation for 30 years. During this time I have analysed many fluoridation studies, published scientific papers, lectured on this subject at international conferences and congresses, was nominated as an expert in official hearings, and have discussed the problem in panels, in newspapers, on radio, and on television.

I would now like to inform your readers about the present stage of development of water fluoridation mainly in Europe since the resolution of the WHO in 1969:

1. The World health Assembly (WHA) adopted Resolutions in 1969 (WHA22.30), in 1975 (WHA28.64), and in 1978 (WHA31.50) which recommended that Member States introduce community water fluoridation as a safe, inexpensive and effective measure, and urged Member States to consider fluoridation of public water supplies as part of their national plans for the prevention and control of oral disease; and it suggested that, where community water fluoridation is not feasible, alternative methods of achieving optimum daily intake or application of fluorides should be envisaged.

These Resolutions are promoted by the International Dental Federation (FDI),¹ which prepared the Report by the Director General of the WHO, and backed up by Public health Officials with their National Dental Organizations.^2,3 The FDI first recommended water fluoridation in 1951.⁴

2. Scientific analyses of water fluoridation studies and experiments show that none of them can actually prove any caries prophylactic effect of fluoride.^5-47 The "caries reductions" reported by dentists were undoubtedly constructed by dentists (e.g. in the 21-cities-study by H T Dean et al (1942) or in the Grand Rapids/ Muskegon Study by F A Arnold Jr and J W Knutson et al (1950-1962> or are the result of influences other than those of fluorides. The dentist J W Knutson, Assistant Surgeon General, Chief Dental Officer, US Public health Service, was engaged as an expert of the WHO in the expert committee 1957⁴⁸ and an Adviser Member of the health Assembly in 1969.³ In my opinion the dentists in the WHO who recommended water fluoridation as safe, inexpensive, and effective, are not competent in this field of science because the problems are statistical and epidemiological and not problems of dentistry. The dentists in the WHO defend dogmatism instead of relying on facts. It is impossible to prevent and control oral disease by water fluoridation.

3. Whereas the WHO and WHA recommended the introduction of community water fluoridation in 1969, 1975, 1978, water fluoridation was stopped in some of the European Member States of the WHO.⁴⁹ The reason for these cessations of water fluoridation was not a political one, but the consequence of scientific discussion of its effectiveness and side effects. Water fluoridation was stopped in the following States: Federal Republic of Germany⁵⁰ (introduced 1952, stopped 1971); Sweden (introduced 1952, stopped 1971); Netherlands^51-53 (introduced 1953, stopped 1976); Czechoslovakia⁴⁹ (introduced 1958, stopped 1988/90); German Democratic Republic⁴⁹ (introduced 1959, stopped 1990 (Spremberg 1993>; Union of Soviet Socialist Republics⁴⁹ (introduced 1960, stopped 1990); Finland⁴⁹ (introduced 1959, stopped 1993); outside Europe: Japan⁴⁹ (introduced 1952, stopped 1972).

In Europe more than 53 million people who had water fluoridation for many years are now free from it.

4. Dentists and WHO experts have predicted a very large caries increase ("a tide of caries") after termination of fluoridation.⁴⁹ Analyses of the data, however, reveal a significant decrease in dental caries (caries decline) after suspension of water fluoridation in Japan,^49,54 in the Netherlands,⁵⁵ in Prague,^49,56 in the German Democratic Republic,⁴⁹ and elsewhere. Never has any real increase in dental caries been observed after water fluoridation was discontinued.

Furthermore, many fluoride tablet measures were stopped also. In Graz²³ (Austria), for instance, the dental caries of children had increased during the fluoride tablet actions in schools since 1956 and decreased after the stop in 1973.

Rudolf Ziegelbecker
Peterstalstrasse 29
A-8042 Graz; Austria
Tel/fax +43-315-471128

References

1. WHO. Fluoridation and Dental health. Report by the Director-General. A22/P & B/7 29 May 1969.

2. USPHS. Promotion and Application of water fluoridation. Proceedings of the Fourth Annual Conference of State Dental Directors with the Public health Service and the Childrens Bureau. June 6-8 1951. Federal Security Building, Washington DC. Main Library Department of health, Education and Welfare. HEW. RK-301C76-1951.
3. WHO. Twenty-Second World health Assembly, Boston MA, 8-25 July 1969. Part II. Official Records of the WHO No. 177. Geneva 1969 pp 42, 129, 271-274, 300-310, 374-375.
4. "Dr. Rowlett, who is the secretary of the International Dental Federation, is a very persistent fellow. He began beating a path to the doorstep of WHO two years ago in Rome. He found it a bit hard to get the doors open more than just a little crack, but he was persistent..." Leonard A Scheele, US Surgeon General, at the 1951 WHA conference. See Reference 2, p 2.
5. Ziegelbecker R. Gesetzmässigkeiten im Verlauf der Zahnkaries. Prophylaxe 8 73-83 1969.
6. Ziegelbecker R. Nuevos puntos de vista para valora la profilaxis anticaries con fluor. Folia Clinica Internacional 19 539-549 1969.
7. Ziegelbecker R. Kritischer Beitrag zu den Grundlagen der Kariesprophylaxe durch fluoride. Internationales Journal Vitalstoffe  Zivilisationskrankheiten 14 229-233 1969.
8. Ziegelbecker R. Acerca de la demonstración de una acelerada presentación de caries y una retrasada erupción de la piezas dentarias permanentes par el aporte incrementado de fluor. Folia Clinica Internacional 20 332-350 1970.
9. Ziegelbecker R. A Critical Review on the Fluorine Caries Problem. Fluoride 2 71-79 1970.
10. Geyer CF. Kariesprophylaxe  falsch programmiert (II) Zahnärztliche Welt/ Rundschau 79 677-679 1970.
11. Geyer CF. Das Kariesproblem im öffentlichen Gesundheitsdienst. Das öffentliche Gesundheitswesen 32 36-42 1970.
12. Ziegelbecker R. Kritischer Beitrag zur Kariesprophylaxe mit Fluoriden (Autorrefereat). gwf-Wasser/Abwasser 111 463-464 1970.
13. Ottestad P. Re fluoridation of Drinding water in Norway. (submitted to the Ministry of Social Welfare, September 1969). Internationales Journal Vitalstoffe  Zivilisationskrankheiten 15 145-149 1970.
14. Ziegelbecker R. Kurze Kritik zur Trinkwasserfluoridierung in Kassel. Städtehygiene 22 66-68 1971.
15. Ziegelbecker R. Betrachtungen zür Fluoridierung, insbesondere in Basel und Grand Rapids (USA). Schweizerische Monatsschrift für Zahnheilkunde 81 192-200 1971.
16. Ziegelbecker R. Falsche Prämissen der Fluorkariesprophylaxe. Schweizerische Monatsschrift für Zahnheilkunde 81 215-239 1971.
17. Ziegelbecker R. Über die Hypothesen der Kariesprophylaxe mit Fluoriden. Protectio Vitae (Internationales Journal) 16 105-109 1971.
18. Ziegelbecker R. Fluoride sind keine Kariesprophylaktika. Erfahrungsheilkunde 20 389-402 1971.
19. Ziegelbecker R, Thomson HM. Comments on the Paper by C. W. Kwant "Sixteen Years of water fluoridation in the Netherlands and its Influence on Dental Decay." Fluoride 6 57-63 1973.
20. Ziegelbecker R. Rechtfertigen kariesprophylaktische Erfolge in der Relation zür Schadensmöglichkeit Fluoreinsatz? In U. Rheinwald: Zahnkaries und fluoride  ein Diskussionsgespräch. A W Gentner Verlag, Stuttgart 1974 pp 53-106.
21. Ziegelbecker R. Statistische Betrachtungen zur Effektivität der Trinkwasserfluoridierung. gwf  Wasser/Abwasser 116 361-364 1976.
22. Waldbott GL, Burgstahler AW, McKinney HL. Fluoridation: The Great Dilemma. Coronado Press, Lawrence KS 1978 pp 423.
23. Celedin A., Ziegelbecker R. Zur Fluortherapie in Österreich Diaita. Beilage zur Erfahrungsheilkunde 28 DII 1979.
24. Sutton PRN. Fluoridation, 1979. Scientific Criticisms and fluoride Dangers. Melbourne 1980 p 284.
25. Ziegelbecker R. Fluoridated water and teeth. Fluoride 14 123-128 1981.
26. Ziegelbecker R. Natürlicher Fluoridgehalt des Trinkwassers und Karies. gwf Wasser/Abwasser 122 495-497 1981.
27. Ziegelbecker R. Zur Beurteilung der Fluoridbelastung in der Umwelt. Proceedings of the IVth International Conference Bioindicatores Deteriorisationis Regionis II. Liblice/Prague 28/6-2/7 1982. Czechoslovak Academy of Sciences, Ceske Budejovice 1986 pp 355-371.
28. Walker G. Fluoridation. Poison on Tap. An Indictment of the Victorian Government Committee of Inquiry, Melbourne 1979-1980, into the fluoridation of Victorian water Supplies. Glen Walker, Melbourne 1982 (458 pages).
29. Ziegelbecker R. fluoride. Nichtöffentliche Sachverständigenanhörung "Fluoride". 10. Deutscher Bundestag. Ausschussfür Jugend, Familie und Gesundheit (13. Ausschuß). Stenographisches Protokoll des Bundestages Nr.57. Bonn 25.9 1985.
30. Diesendorf M. The mystery of declining tooth decay. Nature 322 125-129 1986.
31. Ziegelbecker R., Schöhl H. Submissions (pp 1-164). In: Pro oder kontra Fluorid. Nichtöffentliche Sachverständigenanhörung AOK Wissenschaftliches Institut der Ortskrankenkassen. Protokoll des Gespräches mit Fluoridgegnern am 6 Dezember 1985 im WIdO. WIdO-Materialien Nr. 29, Bonn 1986 (278 pages).
32. Ziegelbecker R. Zur Frage eines Zusammenhanges zwischen Trinkwasserfluoridierung, Krebs und Leberzirrhose. gwf-Wasser/Abwasser 128 111-116 1987.
33. Ziegelbecker R. On the Problem of Data Selections in fluoridation Statistics. XVIth Conference of the Internatinal Society for fluoride Research. ZYMA Auditorium Nyon (Switzerland) 31/8-2/91987.
34. Ziegelbecker R, Ziegelbecker RC. On water fluoridation and its Relation to cancer. Poster. XVIth Conference of the International Society for fluoride Research. ZYMA Auditorium Nyon (Switzerland) 31/8-2/9 1987.
35. Ziegelbecker RCh. Lognormal Distributions  a theoretical model for biomonitoring. Proceedings of the Vth International Conference Bioindicatores Deteriorisationis Regionis I. Ceske Budejovice 23-27/5 1988. Czechoslovak Academy of Sciences, Ceske Budejovice 1989 pp 37-43.
36. Ziegelbecker R. Belastung durch Fluorid im Trinkwasser  Zusammenhang mit Krebs und Leberzirrhose. Proceedings of the Vth International Conference Bioindicatores Deteriorisationis Regionis II. Ceske Budejovice 23-27/5 1988. Czechoslovak Academy of Sciences, Ceske Budejovice 1989 pp 204-211.
37. Ziegelbecker R. Natural water Fluoridation: Multifactorial Influence on Dental Caries in 21 Cities Study. XVIIth Conference of the International Society for fluoride Research. Budapest (Hungary) June 22-25 1989.
38. Colquhoun J, Mann R. The Hastings fluoridation Experiment, Science or Swindle? The Ecologist 16 243-248 1986; 17 125-126 1987.
39. Colquhoun J. Child Dental health Differences in New Zealand. Community health Studies II 85-90 1987.
40. Colquhoun J. Decline in primary tooth decay in New Zealand. Community health Studies 12 187-191 1988.
41. Yiamouyiannis JA. Water fluoridation and tooth decay: Results from the 1986-1987 National Survey of U.S. schoolchildren. Fluoride 23 55-67 1990.
42. Colquhoun J. Fluoride and the decline in tooth decay in New Zealand. Fluoride 26 125-134 1993.
43. Colquhoun J. Is there a benefit from water fluoride? Fluoride 27 125-134 1993.
44. Ziegelbecker R. Stellungnahme zur Arbeit: Nell A, Steinhauser G, Schiestl W, Sperr W. Messung des Trinkwasserflüoridgehaltes in Vorarlberg. Brief an die Herausgeber. Wiener Klinische Wochenschrift 106 401-405 1994.
45. Schöhl H. Gebißkrankheiten und Gesundheit. Medizinisch Literarische Verlagsgesellschaft mbH Uelzen 1994 (293 pages).
46. Bruker MO, Ziegelbecker R. Vorsicht Fluor. emu-Velags GmbH, D-56112 Lahnstein, 4, Auflage 1995 (424 pages).
47. Ziegelbecker R, Ziegelbecker RC. WHO data on dental caries and natural water fluoride levels. Fluoride 26 263-266 1993.
48. Knutson JW. Dental Effects of fluoride. In: WHO Expert Committee on the Public health Aspects of water Fluoridatio. WHO/DH/II, Geneva. 1957 pp 1-13.
49. Künzel W. Caries decline in Deutschland: Eine Studie zur Entwicklung der Mundgesundheit. Hüthig GmbH, Heidelberg 1997 (351 pages).
50. Wolfskehl O. Letter to Rudolf Ziegelbecker. Städtische Werke AG Kassel. 20/7 1971.
51. Bergman-van den Burg L, Stichting Waakzaamheid Drinkwater. Letter to Rudolf Ziegelbecker. 21/3 1976.
52. Minister van Volksgezondheid en Milieuhygiene. Leidschendam, 8 September 1976. Nederlandse Staatscourant 20 September 1976.
53. Moolenburgh H C. Letter to Rudolf Ziegelbecker. Haarlem, October 1976.
54. Miyazoki H., Motimoto M. Changes in caries prevalence in Japan. European Journal of Oral Sciences 104 452-458 1996.
55. Kalsbeek H, Kwant GW, Groeneveld A, Backer-Dirks O, Eck AAMJ, Theuns HM. Caries experience of 15-year-old children in the Netherlands after discontinuation of water fluoridation. Caries Research 27 201-205 1993.
56. Lekesová L, Rokytová K, Salandová M, Mrklas L. Oral health of children in Prague after the cessation of drinking water fluoridation. 4th Symposium on Preventive Dentistry. Prague 1996.