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27 Mar 2017

Transcript: AMA President Dr Michael Gannon, ABC Radio Adelaide, 27 March 2017

Subjects: Fluoride


JULES SCHILLER:  Dr Michael Gannon joins me – he's President of the AMA, of course. How are you going, Dr Gannon? Thanks for joining the program.

MICHAEL GANNON:  It's a pleasure, Jules.

JULES SCHILLER:  Are you surprised with how incendiary the fluoro debate is? I mean it seems to me to be quite a benign kind of program to help tooth health really but it really does get people fired up sometimes, doesn't it?

MICHAEL GANNON:  Yeah it does and you're quite right, it gets conflated with the anti-vaccination movement, and somewhere along the line there are people who have a strict libertarian view of how society should run and feel threatened that governments should make these decisions on our behalf. But the truth is that the science is there, they first discovered – you're quite right, Adelaide was first. So all those rude jokes about Adelaide water can stop right now.

JULES SCHILLER:  [Laughs] Okay, right, yeah.

MICHAEL GANNON:  They first discovered in North America that the communities where the water supply had a decent level of fluoride in the water naturally had much lower incidents of dental care, tooth decay, et cetera and there are many parts of the world where the level of fluoride in the water is sufficient that it doesn't need to be added. But in many parts of Australia it does, and we've seen a significant corresponding fall in the rate of both benign and more serious dental disease over the journey.

JULES SCHILLER:  A lot of people say that you can have too much fluoride and that it can affect your bones or affect your teeth, is that true?

MICHAEL GANNON:  Well you can have too much fluoride, and you can always have too much of a good thing. And it's absolutely incumbent on the authorities that they get the dosing right. The amount of fluoride that's added to the water is minute and it's certainly not at a level that poses any threat to community safety. As I say, if you live in a part where the water table or the dams contain sufficient doses of fluoride, then it's not added and, depending on where you live, it's added.

Now you've already made reference to the fact that in Queensland and in New South Wales, where local government authorities have the right to make this determination on behalf of their population, they've fallen victim to scare campaigns and fluoride has been taken out of the water.

So the public health triumph that we should be talking about – gradually increasing the proportion of the population that gains the benefit from having fluoride in their tap water - unfortunately we're seeing the move backwards, with local government authorities - on the basis of scare campaigns - taking fluoride out of the water.

JULES SCHILLER:  I think, you know, that the main claim of a lot of the anti-fluoride groups, Dr Gannon, is that you're kind of – well they say you're medicating everyone equally, you're not taking into account age or specific medical conditions so it's like a blanket medical approach to a population and it should be more specialised, and they seem to resent that. Is there anything in that?

MICHAEL GANNON:  Look, I think the ultimate aspiration for someone in my job is to see all Australians have access to an equal quality of health services. That's what we spend a lot of time in the AMA thinking about. We think about how can we possibly get the same quality of health services to someone on a health care card as to someone who's wealthy in the inner suburbs of Adelaide?

Here's a good example of the way that we can deliver the same health benefits to everyone across the community. It's really cheap, it's really safe, and let's face it: dental services are not cheap. This is one of the ways that we can overcome that inequity which exists in our society. We can reduce the number of people getting extremely sick, not just acutely, from things like periodontitis, dental abscesses, but in the long term as well. We know of the association between poor oral hygiene and heart disease. So this is a good example, like vaccination, of a way where we can even out the benefits of the whole community.

JULES SCHILLER:  I mean obviously with Pete – I know Pete Evans, you would say he's part of the naturalist movement of people who, in the more extreme elements, don't like vaccinations and they're into non-toxicity and so fluoride has really been drawn into that debate that it's not a natural substance. That it's a toxin. And that element of society, I guess you mention Lismore Council, so you've got Byron Bay and that kind of element of society seems to be gaining in popularity. Does that worry you?

MICHAEL GANNON:  Well it's a huge concern and you know, I'd recommend that anyone driving along the North Coast of New South Wales hold their breath. Unfortunately you can't do it for 100 kilometres.

The real problem with this is that, for example, vaccination only works when we achieve herd immunity, and there's people out there who are making themselves and their own children part of international microbiological experiments. It might be fabulous in the group-think environment that is the Byron Bay community to eschew the benefits of vaccination and fluoride in the water and any other number of proven health measures, but when your child grows up and goes to Bali for the first time, or travels into Thailand or Indonesia, that's when they will get the full force of not being protected against a group of infections that we've just about consigned to the history book in Australia.

JULES SCHILLER:  And of course, you've got this bizarre thing of, you know, hippie groups, or let's say naturalist groups and far right wing groups, kind of having similar opinions on public health, which is just bizarre.

MICHAEL GANNON:  Well look, it is true that extremists at both ends of the political spectrum often find themselves agreeing. These are really simple proven public health measures. I mean, one of the other ones that we don't talk a lot about, but for many years in Australia we've put folate in the bread. So there you go, there's another conspiracy theory for you there – the Government's putting folate in bread. But very simply, at population level that reduces the number of kids born with spina bifida.

These things are not done willy-nilly, they're done on the basis of very careful scientific analysis. When it comes to the National Immunisation Schedule, whether you're talking children or adults, it goes through numerous quality checks before vaccines are put on the schedule and then they are subject to continuous scrutiny, both to their safety and their effectiveness. These represent very judicious, sensible employment of limited healthcare dollars.

JULES SCHILLER:  Just a couple of questions that have come from the SMS. Dr Michael Gannon I'm talking to, president of the Australian Medical Association, about the anti-fluoride movement or some sentiment – let's just call it that – that seems to be bubbling under the surface of the community. Martin has said that he heard that asthma rates went up significantly after fluoride was introduced. Is there any scientific evidence to that?

MICHAEL GANNON:  Well, what we know is that asthma rates have increased over the last generation or two and everyone's theory is as good as the next one. So what we've seen is an increase in the rate of not only atopic asthma, but other allergic diseases. So everyone's theory is as good as the next one.

But no, there's no convincing evidence of anything like that. The thought that fluoride is toxic – so is every other element in the periodic table. So if you fill your body full of sodium or magnesium, potassium, you name it, they're all lethal in dangerous doses. But fluoride in the microscopic parts per million doses that it's put in our tap water is a bonanza for good dental health, and for those of us who don't have the same access to high quality dental care as much as others, along with brushing your teeth it's the best we can offer people.

JULES SCHILLER:  Alright, thank you. Dr Michael Gannon there, president of the Australian Medical Association, giving us the history and the benefits of fluoridation, which still can cause a little bit of controversy.


27 March 2017

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Published: 27 Mar 2017