14 Nov 2014 – last update 2022

Fluoride in public water supplies intro

Following on from information on fluoride concentrations of the drinking water of western European communities, I have listed fluoride concentrations in drinking water of the 10 largest cities or towns in each of Scotland and the Netherlands at the bottom of this page. Neither country inflicts forced fluoridation on its population. Scotland ceased in 1983 (Attwood 1992, 41) and the Netherlands ceased in 1973, prior to which 38% of the Dutch population was directly subjected to it (Attwood 1992, 33). It can be seen that the fluoride concentrations are uniformly very low in comparison with the typical nominal concentrations used for artificially fluoride-contaminated water of 0.7 to 1.0 ppm.

Fluoridation of salt, milk, etc

Salt fluoridation and milk fluoridation, and any other kind of artificial fluoridation of food or drink, also appear to be non-existent or negligible in both countries. “In Europe, meaningful percentages of users [of fluoridated salt] have been attained only in Germany (67%) and Switzerland (85%).” (Marthaler 2013, 140) and “The sale of fluoridated salt would be legal in Greece and in the Netherlands but there seems to be no interest in this preventive method.” (Marthaler 2013, 148). The use of fluoride tablets/lozenges or drops has not been routine in western Europe for many years. In the Netherlands, the massive “improvement in dental health” in 12-year-old children after the cessation of forced fluoridation “could not be attributed to administration of fluoride supplements [sic], because the sales of fluoride tablets had always been low and were decreasing continuously.” (König 2004, 170) In Scotland the Childsmile program is in place, and no kind of systemic artificial fluoridation is part of that program. The only references to milk fluoridation in Scotland which were found (elsewhere) were a couple of papers from the first half of the 1980s. I didn’t find any information on milk fluoridation in the Netherlands.

Tooth decay statistics

The Malmö University website has information on global oral health, which is linked to by the World Health Organization website. This includes DMFT (decayed, missing and filled permanent teeth) data for 12-year-olds, and dmft (decayed, missing and filled deciduous teeth) for various younger age groups. The way the information is presented has changed from when I updated this page in 2019. Previously, the latest information for Scotland was from 2010-2011, with a DMFT of 0.7 for 12-year-olds. This information is no longer available on the Country Areas page, but there is a page about the Childsmile program which indicates that the DMFT and dmft for Scottish children have fallen since the program was fully implemented in 2011. The page states: “The Scottish Government and National Health Service (NHS) Scotland are at the forefront of child oral health improvement.”

The figure for DMFT for 12-year-olds in the Netherlands was 0.6, from 2006, but for some reason now appears on the Country Areas page as 0.80, from 2002. Previously in the Netherlands, the feared deterioration of dental health “miraculously did not happen; on the contrary, the changes in the average DMFT of 12-year-old children over the whole country show that the decrease of caries prevalence had only just started when water fluoridation ceased in 1973; the average DMFT of 8 [in 1965 (Marthaler 2004, 176)] in 12-year-old children consistently decreased to a DMFT of 1 by the mid 1990s” (König 2004, 170). The number given for way back in 1911, long before forced fluoridation started anywhere and long before fluoridated toothpaste became commercially available, is 1.30.

DMFT for 12-year-olds in the Republic of Ireland, which is the only country in Europe in which the majority of the population is directly subjected to forced fluoridation, is 1.60, from 2001. The figures for the majority force-fluoridated USA (1999-2004) and Australia (2009), respectively, are 1.20 and 1.05. The trend in Australia since recording 0.8 in the year 2000 has been upwards. Comparing dmft for Scotland and the Netherlands, on the one hand, with Ireland, the USA, and Australia, on the other, reveals a similar picture of no clear benefit.

Conclusion

The myth that fluoride is a nutrient was debunked by animal studies conducted in the 20th century, a fact which has been officially recognised in the US and Europe. No individual person requires any fluoride for good dental health. The examples of Scotland and the Netherlands show that countries also do not require any form of artificial food or drink fluoridation, or fluoride concentrations in drinking water comparable to those used for forced fluoridation, in order to achieve rates of dental caries in 12-year-olds which are low both in comparison with force-fluoridated countries, and by historical standards.

The forced fluoridation floggers would perhaps respond that such comparisons do not take confounding factors into account. If they had some good quality, independent research they could cite maybe they would have a case. In reality, the marketing “studies” they rely on are of very poor quality, take no account either of several potentially important confounding factors or of systematic measurement error, and are typically funded by corporations such as Colgate-Palmolive, so they do not have a leg to stand on. Note that the evidence for benefit in adults is even weaker than that for children, if that is possible.

Fluoride in public water supplies data

All figures below are in parts per million (ppm), or equivalently milligrams per litre (mg/L).

Scotland

Scottish Water

Glasgow

Milngavie C3 (G22 5AA) less than 0.12, Picketlaw (G76 0AA) less than 0.12, Carron Valley B (G63 0AA) less than 0.12

Edinburgh

Glencorse A (EH17 8FA) less than 0.12, Glencorse B (EH7 4HW) less than 0.12, Glencorse C (EH9 2DS) less than 0.12, Glencorse D (EH11 4JY) less than 0.12

Aberdeen

Mannofield East (AB10 1AA) less than 0.12, Mannofield West (AB15 9HL) less than 0.12, Mannofield South (AB12 3QT) 0.12, Craigie (AB23 8EU) less than 0.12

Dundee

Clatto West (DD2 2JQ) less than 0.11, Clatto East (DD5 3DQ) less than 0.12

Motherwell

Daer C (ML1 1QZ) less than 0.12

Falkirk

Carron Valley A (FK1 1LD) less than 0.12

Coatbridge

Balmore B (ML5 2LB) less than 0.12, Balmore C (ML5 3AJ) less than 0.12

Hamilton

Daer Camps A (ML3 6AA) less than 0.12, Daer C (ML3 8PZ) less than 0.12

East Kilbride

Daer B (G75 8SA) less than 0.12

Dunfermline

Glendevon A (KY12 7AU) less than 0.12

The Netherlands

Amsterdam

0.09
Waternet

Rotterdam

Berenplaat (3197XA) 0.21, Kralingen (3113AA) 0.21
Evides

The Hague

Scheveningen 0.23, Katwijk 0.23, Monster 0.23
Dunea Duin & Water

Utrecht

Beerschoten (3551AA) 0.08, Bunnik (3525TG) less than 0.05, De Meern (3454BB) less than 0.05, Groenekan (3565AB) 0.07, Leidsche Rijn (3542AA) less than 0.05, Soestduinen (3512JN) 0.09
Vitens (water quality)
Vitens (water quality reports)

Eindhoven

Eindhoven 0.075, Welschap 0.06
Brabant Water

Tilburg

0.06
Brabant Water

Groningen

De Punt (9726AD) 0.06, Nietap (9738AL) 0.06, Onnen (9723GA) 0.14
Waterbedrijf Groningen

Almere Stad

Harderbroek (1315AD) 0.07, Fledite (1322BH) 0.07
Vitens (water quality)
Vitens (water quality reports)

Breda

Dorst 0.12, Prinsenbosch 0.08, Oosterhout 0.1
Brabant Water

Nijmegen

Heumensoord (6511BD) less than 0.05, Fikkersdries (6545EH) less than 0.05
Vitens (water quality)
Vitens (water quality reports)

References/Links

1. Attwood D (1992). Dental health of children before and after the cessation of water fluoridation: volume 1 [PhD thesis]. Department of Conservative Dentistry, University of Glasgow.
2. Childsmile
3. König KG (2004). Clinical manifestations and treatment of caries from 1953 to global changes in the 20th century. Caries Research 38: 168-172.
4. Malmö University Oral Health Country Areas Profile Project
5. Malmö University (Childsmile)
6. Marthaler TM (2004). Changes in dental caries 1953-2003. Caries Research 38: 173-181.
7. Marthaler TM (2013). Salt fluoridation and oral health. Acta Medica Academica 42(2): 140-155.
8. WHO Health topics: Oral health