§ Mr. Lawrence
To ask the Secretary of State for Health (1) what advice his Department has received concerning dangers to health arising from the use of fluoridated toothpaste in areas where the level of fluoride in the water has been raised to 1 part per million;
(2) what advice his Department has received concerning the risk of discolouration of teeth where fluoridated toothpaste is used in areas where the level of fluoride in the water has been raised to 1 part per million;
(3) whether his Department monitors the effect of fluoridated toothpaste and other freely available fluoride additives in areas where the level of fluoride in the water has been raised to 1 part per million;
(4) what guidance he has given to dentists, hospitals, the retail trade and other affected groups about the sale 557W and use of fluoridated toothpaste in areas where the level of fluoride in the water has been raised to 1 part per million.
§ Mr. Dorrell
The total daily oral intake of fluoride from food, water and fluoridated toothpaste in those areas in the United Kingdom where the drinking water contains fluoride at 1 part per million, whether present naturally or added, is too low to have any adverse effect on health.
A study to compare the effect on enamel formation of the use of fluoride toothpaste in fluoridated Birmingham and non-fluoridated Leeds concluded that while there was a higher level of mild fluorosis in the fluoridated area there was no evidence of an increase in the higher grades of fluorosis, and that the use of fluoride toothpaste by young children in fluoridated areas was unlikely to produce aesthetically unacceptable levels of enamel fluorosis.
Not all toothpastes are licensed medicinal products. The EC cosmetics directive permits the addition of fluoride ion up to 1,500 ppm. No toothpaste on the United Kingdom market contains more than this and most are limited to 1,000 ppm. A voluntary agreement has been reached with the Cosmetics, Toiletries, and Perfumeries Association to include information on packaging about the amount of toothpaste to be used when cleaning teeth. A toothpaste containing more than 1,500 ppm would only be available on prescription.
§ Mr. Lawrence
To ask the Secretary of State for Health what evidence his Department has of a level of ingestion at which sodium fluoride becomes carcinogenic; and if he will make a statement.
§ Mr. Dorrell
The Department has no evidence that shows sodium fluoride to be carcinogenic at any level of ingestion.
The Committee on the Carcinogenicity of Chemicals in Food, Consumer Products and the Environment—COC—reviewed the animal data on the carcinogenicity of sodium fluoride in 1990. The only noteworthy finding was a statistically significant dose-related positive trend for the incidence of osteosarcomas in one strain of male rats which was observed in one carcinogenicity study. No osteosarcomas were found in female rats in the same study, or in mice in a parallel study. A further study in another strain of rats showed no evidence of neoplastic effects.
The COC noted that all well conducted in vivo mutagenicity tests were negative; that limited epidemiological data revealed no relationship between bone cancer rates in humans and fluoride concentrations in drinking water; and that there was no available evidence that fluoride causes bone cancers in humans, even in people in whom excessive long-term exposure to fluoride has caused skeletal fluorosis. It concluded that there was no evidence for carcinogenic risk to humans from exposure to fluoride.