NEW, OR BIASED, EVIDENCE ON WATER FLUORIDATION

The recent review, 'New evidence on fluoridation', by Diesendorf, Colq uhoun, Spittle, Everingham and Clutterbuck (Aust N Z J Public Health 1 997; 21: 187-90) claims a consistent pattern of evidence pointing to f luoride damaging bone, a negligible benefit in dental caries reduction from ingested fluoride, and any small benefit from fluoride coming fr om the action of fluoride at the tooth surface. Public health authorit ies are allegedly reluctant to pursue such evidence. In the interest o f scholarly debate, invited by Diesendorf et al., this reaction paper examines six separate areas raised in the original paper: fluoridation and hip fracture; fluoridation and osteosarcomas; pre-eruptive and po steruptive benefits in dental caries reduction; fluoride ingestion; be nefit in dental caries reduction for contemporary Australian children; and bias of health authorities and responsible science. Numerous exam ples of bias in the identification, selection and appraisal of the evi dence on water fluoridation presented by Diesendorf et al. are develop ed. Further, this reaction paper puts forward both studies and apprais al indicating that water fluoridation should continue to be regarded a s a safe and effective public health measure.