Press Release WHO/14-15 February 1994
WHO Advocates Affordable
Fluoride Toothpastes for the Developing Countries
Fluoride toothpaste is now the most widely used method of prevention in
the world, but it cost remains a deterrent for many of the world's poorer populations.
This was the conclusion reached by a WHO expert Committee meeting a few month
before this year's World Health Day, on 7 April, which will focus on oral health.
Among measures to promote greater access to these toothpastes, the Committee
proposed exemption from duties and taxation, since fluorides are added for the
sake of public health and not for cosmetic purposes.
According to data presented at a recent meeting in Geneva, more than 800 million people throughout the world now benefits from fluorides, the most common natural occurring fluoride chemical compounds, as a means of controlling caries and maintaining oral health. This is mostly achieved through the fluoridation of water for (210 million people), salt (50 million) or toothpaste (450 million). Ground water in its natural condition almost always contains fluoride, but in concentrations that vary widely from one place to another.
Fluoride has been known for several decades to be effective against dental caries, and it acts in several ways. When present in dental plaque and saliva, it hastens the remineralization of incipient enamel lesions before cavities can become established. It also interferes with glycolysis, the process by which bacteria metabolize sugars to produce acid. In higher concentrations, it has a bacterial effect and when ingested during the period of tooth development, fluoride is thought to make the enamel more resistant to later acid attacks.
The other side of the story is that high concentrations of fluoride may give rise to fluorosis, with the appearance of white patches and lines on the teeth. Mild fluorosis cannot be detected by the untrained eye, but may present unaesthetic forms when it is more severe. The ideal balance must thus be found to ensure the benefit of effective fluoride protection against caries while avoiding the damaging forms of fluorosis, which the WHO experts nevertheless regard as acceptable in a mild form.
From the Public health standpoint, they advocate as a general rule a strategy of low but regular exposure to fluorides, while the applications of higher concentrations, especially gels, should be reserved for patients particularly vulnerable to caries.
This goal is described in the report adopted in Geneva as "maintaining a constant, low-level of fluoride in as many mouth as possible", and when it is attained by adding fluoride to water, salt or toothpaste, the change of incidence of dental caries in the population in question soon becomes evident. Many scientific studies show that when significant population exposure to fluoride begins in any community where previously there was little of none, a decline in the incidence of dental caries in children will become evident within about two years. Incidence among adults will also be reduced, although the decline will be less evident.
For programs of prevention to be effective, all sources of fluoride absorbed by individuals in their environment must be taken in account, so that total intake does not succeed the optimal dose for oral health and health in general. The experts convened by WHO have stressed that in communities where water fluoridation is not possible, for technological or financial reasons, fluoridation of salt may be regarded as a suitable alternative. Switzerland is a good example of a country where this method has resulted in a large reduction in dental caries in the children and young people. Another alternative is fluoridation of milk, a process which has shown promising results in certain community projects undertaken by the WHO.
However, it is the use of fluoride toothpastes that has been subjected to the most rigorous clinical testing. More than 100 trials have shown that brushing the teeth with a fluoride toothpaste will reduce the incidence of dental caries by about 25% in only 2-3 years and more than twice that figure if used consistently from infancy. In view of the fact that cost remains a barrier for its widespread use in many developing countries, the experts called for efforts to make fluoride toothpastes, that are effective in preventing dental caries, affordable for use by underprivileged populations.
They also recommend that water fluoridation should be introduced and maintained whenever possible, since it is a safe and cost-effective process. They recommend a range of fluoride concentration for water of 0.5 to 1 mg per liter. Fluoridated salt should contain a minimum concentration of 200 mg per kilo.
This clear stand by the WHO Expert group in favor of fluoridation for the prevention of dental caries comes as a curtain raiser to 1994, which Dr Hiroshi Nakajima, the Director-General of WHO, has decided to devote to the theme of oral health. Not only on 7 April, but throughout the year that is now starting, the Member States of the Organisation, the medical profession and the public will be mobilized to give greater attention to this important aspect of public health.
Strange, very strange as we can read in an official previous communique from the same WHO in 1984;
"NO Denial" from WHO
In official communique No w2/450/f2, dated October 15, 1984, issued on behalf of the Director-General of the World Health Organisation (Geneva) in response to a detailed 14 point, multi-disciplined interrogatory, the Director- General does not deny that serious specific injury and death results from the ingestion of, or exposure to any fluoride compound, in any amount, and tacitly withdraws from all assurances of "safety" or "benefit" made in the organisation's name.
Furthermore the World health Organisation will not accept responsibility for any such injury cause resulting from dissemination of the toxin throughout the environment, despite widespread publication of the "resolutions" and approval for universal dissemination.
This officially confirms the report dated September 21, 1984, from the Gosford City Council that "the World Health Organisation will not sign any statement that fluoridation of water supplies, at one part per million, will not have any harmful side effects on any person's health irrespective of medical history"
In August 1979, the World Health Organisation deliberately evaded a specific request from Mr Jas. R. Bilings of Wellington, NZ: to affirm "that the consumption of fluoridated water at one part per million will not cause future harm to anyone."
In considerations leading up to the outlawing of fluoridation in November 1971, the Swedish Parliament noted that the World Health Organisation was "in favor of fluoridation", but it was also noted that the WHO had once been "in favor of DDT".
Furthermore the Swedish Medical Board could not obtain from the WHO to support the WHO claim that "fluoridation is safe".
For more information about fluoride:
* "Fluoride the Aging Factor"
By Dr. John Yiamouyiannis
"You could be one of the more than 100.000.000 Americans being poisoned or one of the estimated 30.000 to 50.000 who die from fluoride each year"
(Fluoride the Aging Factor ISBN 0-913571-01-6)
TESTIMONY ON FLUORIDATION (JUNE 29, 2000)
* Fluoride and hip fractures
* Analytical Chronology of Fluoridation: Politics vs Science
Call To Awaken Page with many articles under the section "Fluoride"
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