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I keep seeing this claim about the unpopularity of water fluoridation parroted.

Despite dental pressure, 99% of western continental Europe has rejected, banned, or stopped fluoridation due to environmental, health, legal, or ethical concerns

I want to believe it because it seems to be a pretty well sourced point that anti-Fluoride side is making. It shows up all the time on my FB feed -- largely thanks to a slew of friends that are behind Flouride Free Houston. Woman with sign, 98% of Europe banned water fluoridation

Other sites, like FluorideAlert.org make similar claims.

As the following table shows, only 3% of the population in western Europe is currently consuming fluoridated water. [...]

To see the water fluoridation status of OECD nations, click here. To see a complete list of the 27 countries in the world that have at least one water fluoridation program, click here.

Similar claims appear on the video "Which Countries Fluoridate Their Water?".

And, this very image was again shared by PreventDisease.com -- a Facebook Page with 282k followers as of the posting.

Is there any truth to these claims about the adoption/banning of water-fluoridation?

Update

In light of the information in the comments, I believe we'd be committing ignoratio elenchi to exclude mention of water and milk fluoridation in an accepted answer. I didn't know about either of these when I asked the question. It seems that some of the abandonment of water fluoridation is because of these alternatives: most of Europe seems to be treated by one of these two methods. Neither of these two strategies are mentioned by the anti-fluoride camp. They exclude them and leave the reader to draw the false conclusion in ignorance that the only form of fluoridation is water fluoridation -- the method the USA employs.

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Evan Carroll
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    Not if 3% get fluoridated water. Unless 2% get it despite a ban. – matt_black Sep 02 '12 at 19:56
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    And many of the countries who don't fluoridate water, **do** fluoridate table salt or milk so the public still consume fluoride. Moreover, fluoridation has a bigger measurable effect (try comparing *regions* with and without not countries) on oral health than the entire dentistry profession. – matt_black Sep 02 '12 at 20:16
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    The original question diverged from the title - it asked about both the banning of fluoridation and the effects. I focussed it on just one claim. If you want to ask about the effects, please write a separate question - but check for duplicates on the [fluoridation] tag first. – Oddthinking Sep 03 '12 at 00:45
  • All the anti-fluoridation commentary just serves to remind me of Mandrake (http://www.youtube.com/watch?v=Qr2bSL5VQgM&feature=fvwrel). I think @matt_black is right here-- table salt is fluoridated in portions of Europe that don't have centralized water supplies (according to http://en.wikipedia.org/wiki/Fluoride) – mmr Sep 03 '12 at 01:45
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    This wikipedia page covers it pretty well, and cites sources: http://en.wikipedia.org/wiki/Fluoridation_by_country In summary, most don't fluoridate water, but it's not explicitly "banned" in many places. Most countries add fluoride to milk or table salt instead. Should we still answer this question? It'll literally just be a regurgitation of that wikipedia article. – John Lyon Sep 03 '12 at 05:27
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    And there's more addressing the claim on fluorideinfo - they specifically mention adding fluoride to table salt instead of water in Europe is [in part due to technical difficulties](http://fluorideinfo.org/fluoride_claims-vs-facts.html) (their much older, smaller scale water systems) – John Lyon Sep 03 '12 at 05:31
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    @jozzas I think this is a good example of how to mislead with a statement that is at least partially true, so I'd be in favour of this being answered. – Andrew Grimm Sep 03 '12 at 07:03
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    This is a mix of claim close to truth (2-3% of EU population not getting fluoridated water), with false claim (that it was banned or declared not safe). If fluoridation was discontinued because of use of fluoridated toothpaste and other fluoridated supplements, it's hardly a ban. – vartec Sep 03 '12 at 08:59
  • [Reasons why some European countries "shun" water fluoridation](http://waterfluoridationcenter.org/papers/2001/antifluoride.html) – Oliver_C Sep 03 '12 at 09:34

2 Answers2

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As for claim, that "98% of Europe banned water fluoridation". Without going much into detail:

  • population of European Union is 503 million;
  • according to claim's source, following EU countries have at least one active fluoridation program:
    • UK (62mln, 11% using fluoridated water)
    • Spain (47mln, 11% using fluoridated water)
    • Poland (39mln, 1% using fluoridated water)
    • Ireland (5mln, 73% using fluoridated water)

So countries with active water fluoridation (meaning they don't have ban on national level) account for 30% of EU population.

vartec
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    We have a definition problem. Using these figures + World Bank population figures (via Google): UK: 62,641,000 * 11% + Spain: 47,190,493 * 11% + Poland: 38,216,000 * 1% + Ireland 4,487,000 * 73% = 15.7m = 3% of EU. So 97% of European population are (allegedly) without flouridation. The difference sounds like noise. – Oddthinking Sep 03 '12 at 09:28
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    @Oddthinking It seems fairer to count the whole of the UK as backing fluoridation rather than only the 11% who actually drink it. Since the UK hasn't banned it, which was the claim. – Nick Sep 03 '12 at 09:32
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    @Oddthinking: wouldn't you agree, that "97% without flouridation" and "banned for 97%" are quite different claims? Since these countries have active water fluoridation, it's quite obvious that they don't have countrywide ban. And I doubt if such a thing can be regulated by local bylaws. – vartec Sep 03 '12 at 10:00
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    @Nick, Vartec: This is what I was clumsily alluding to in "definition problem". The *title* of the question and the banner on the beach referred to "banned". The cited fluoridation.com claim refers to "rejected, banned, or stopped", which is far looser. The FluorideAlert.org claim is merely that they aren't "currently consuming". Vartec has, quite correctly, cited the particular claim he was targeting. (I also agree that these four *countries* haven't banned fluoridation, but that still leaves an far-fetched out for local governments (at whatever level is appropriate for water decisions). ) – Oddthinking Sep 03 '12 at 10:18
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    @vartec, though I agree with you and started writing this answer; in the UK fluoridation is at the discretion of local authorities: http://www.legislation.gov.uk/ukpga/2003/37/section/58 – Ben Sep 03 '12 at 19:49
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    I would suspect that some of the decisions not to add fluoride to the water in the areas where it is not banned may be a financial decision or operations decision rather than stand against the "unsafe" aspect of the chemical. – Chad Sep 04 '12 at 14:29
  • @Chad: right, decisions that it's simply not needed anymore with fluoridated toothpastes etc. – vartec Sep 04 '12 at 14:32
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    Even if fluoridation were compulsory, not every area would do it simply because quite a lot of water is naturally fluoridated and it makes no sense to add extra fluoride. Or is natural fluoride OK because it is natural? – matt_black Jan 13 '13 at 21:22
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    I agree with Oddthinking's calculation. If in the UK 11% have fluoridated water, that may mena that 89% of local authorities have banned it, so you can't count 100% for the country. Otherwise, by the same reasoning you could say 100% of the EU has fluoridated water, since at least part of it has banned it. – stevenvh Jan 15 '13 at 17:25
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According to this report "fluoridation schemes operate in five countries in Europe -- in the UK, The Irish republic, Spain, Poland ans Serbia", for a total coverage of about 13,677,000 people (even in those countries only some parts are covered). Excluding Serbia and Poland that would be 13.397,000. According to Google Western Europe has a population of about 400 million (but there is no real agreement as to which countries exactly constitute western Europe).

This would put fluoridation coverage at about 3.3% of the population of Western Europe. So the last quote seems quite truthful.

This of course doesn't say much about why certain regions do or do not operate fluoridation. They did not necessarily ban it, specially not these countries that are providing fluoridated water in some regions. UK, Ireland and Spain alone constitute 28% of Western Europe, and it doesn't seem they have any kind of ban.

On the other hand, what is the difference between banning and just not fluoridating? It is something that in a given region has to be decided for all, at a governmental level, you cannot say everybody can do what he wants, because everybody drinks the same water. So either you decide to fluoridate, or you don't, ban perhaps is a somewhat misleading term, rejection would be better.

About the first quote, I think that at least in some cases fluoridation seems to be rejected because it just seemed to not provide enough benefits, not neccessarly

due to environmental, health, legal, or ethical concerns

The 99% number might be about right as they have excluded the UK and Ireland by saying Continental (quite arbitrarily in my opinion, they could have said Germany and say 100%).

Fela
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    You should mention the fact that many countries get fluoride through other means. For example, fluoridated table salt is extremely common throughout France. – John Lyon Sep 03 '12 at 23:06
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    I can't speak for all of Europe, but at least in Poland fluoridation isn't employed country wide because chlorination is far cheaper and we are supposed to get our daily fluoride dose from toothpaste. – Hubert Kario Sep 04 '12 at 16:17
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    @HubertKario Chlorination and fluoridation are totally separate issues despite both being halogens. – Loren Pechtel Oct 09 '15 at 03:37
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    flouride is also in toothpaste, I believe – Magisch Jul 18 '17 at 11:43
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    Toothpaste fluoridation (and applying fluoride to the enamel of the teeth) is a different process than injestion of fluoride (in water, in salt, etc.). The first is supposed to make the enamel harder. In the second the fluoride circulates in the blood and is supposed to facilitate bone development (including new teeth in children). – GEdgar Jul 18 '17 at 14:01