Response from A/Minister for Health

GENRE: Email RESPONSETO: Darryl TAUTHOR: Minister for Health, Patrick Conlon

DATE SENT: Monday, August 23, 2010 12:53 PM

TITLE: Response from A/Minister for Health

STATUS: Reply of response

UPDATES: Any updates should be posted in the comments section below


REF: 2010MHE-02719

Dear Mr Turner

Thank you for your letter of 4 August 2010 to the Premier, Hon Mike Rann MP and my Ministerial colleagues, about fluoridation of the drinking water supply in South Australia.  As this matter falls within the health portfolio, the Premier asked me to respond on behalf of Government.

The following information is provided by the Department of Health in response to your concerns:

The Department of Health, together with other Australian health agencies and the National Health and Medical Research Council (NHMRC), continually investigates the safety of fluoridation of drinking water.  On the basis of these investigations and consideration of all available evidence, the Department has concluded that fluoridation of drinking water supplies is a safe and effective means of preventing dental caries.

The National Oral Health Plan states that ‘fluoridation of public water supplies is the single most effective public health measure for reducing dental caries across the population, with its most pronounced effects among those who are disadvantaged and most at risk’.  The NHMRC issued a similar recommendation in 2007 following its latest review of the scientific evidence.  The recommendation and the review can be accessed at the web address

The University of York review, which Mr Turner cites in his letter, concludes that fluoridation reduces dental caries.  In addition, other international bodies, such as the World Health Organization and the US Center for Disease Control and Prevention (CDC), also support drinking water fluoridation.  The CDC identified fluoridation as one of the 10 great public health achievements of the 20th century.

The Australian Consumers Association, through its journal ‘Choice’, stated in 2007 that there is solid scientific evidence that drinking water fluoridation improves dental health and that there is no convincing evidence of harmful effects.

On the specific issues raised by Mr Turner:

  • ·         The 2006 National Research Council (NRC) report on fluoride examined the maximum safe fluoride levels for drinking water supplies and concluded that the regulatory limit of four milligrams per litre should be lowered.  As noted by CDC, the report did not question the lower levels actually in use by authorities for water fluoridation.  In Australia these are in the range 0.6 – 1.1 milligrams per litre.
  • ·         The American Dental Association (ADA) did issue interim guidance in 2007 that formula fed to infants should be reconstituted with water containing no or low concentrations of fluoride.  While the ADA strongly supports drinking water fluoridation, it issued the guidance to reduce the potential for dental fluorosis.  However, recent Australian evidence has found no association between use of infant formula and dental fluorosis due to reductions in the concentrations of fluoride in the formula available at supermarkets.
  • ·         A number of studies, including the 2004-06 National Survey of Adult Oral Health, has demonstrated the effectiveness of fluoridation in reducing tooth decay in Australia.  In addition, the prevalence of dental fluorosis in Australia has been significantly reduced by more appropriate use of discretionary sources of fluoride, such as supplements and adult toothpastes.
  • ·         Osteosarcoma is an extremely rare cancer with 9-10 cases diagnosed in children under the age of 15 each year.  The data published by Bassin et al on osteosarcoma has been reviewed by a number of agencies, including the NHMRC and CDC, which found no clear association linking fluoridation to increased risk.  CDC noted that the scientific evidence did not support a link between drinking water fluoridation and the risk for cancer, including osteosarcoma.
  • ·         The hydrofluorosilicic acid used by SA Water to fluoridate drinking water supplies is of a very high quality and is purchased from a certified and accredited company.  Chemical quality is assured on delivery through the provision of a full certificate of compliance from an independent NATA laboratory.

The benefits of water fluoridation and potential negative impacts associated with consumption of optimally fluoridated water supplies have been reviewed on many occasions by national and international health agencies and peak dental bodies, including the ADA.  The outcomes of these reviews have been to support ongoing fluoridation.

Thank you for raising this matter and I trust this information is of assistance.

Yours sincerely



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