Community Water Fluoridation
This essay is going to talk about what water fluoridation is, the ethics, the benefits of water fluoridation, harm principle, the precautionary principle, the issue of compulsory mass medication without consents, respect for autonomy versus other biomedical principles. And at the end see if the benefit of water fluoridationjustify its imposition.
The addition of controlled quantity of fluoride into a public drinking water in other to prevent the tooth from decaying is called community water fluoridation. (Barberio et al., 2017) The first town in the world to be artificially fluoridated is grand rapid Michigan in 1945 (Millen, 2005). The most important way of fluoride use in public health for dental caries prevention is the fluoridation of public water supply. (Gabin et al., 2017) While Whyman, Mahoney and Borsting (2015) states that the alteration of the level of fluoride in drinking water supply is between 0.7 and 1mg/Fluoride is added into water supplies by some countries so as to prevent dental caries
The world health organisation accepted artificial water fluoridation lead by the United States as an active oral health intervention (Pizzo et al, 2007). Artificial water fluoridation is instituted by 30 nations never the less some countries like Germany, Sweden stopped putting fluoride in their water because they are concerned about effectiveness and safety (Pizzo et al,.2007). However research found out that at the moment about 350 million people in the world(5%) globally, consumes artificially fluoridated water(Peckham and Awofeso 2014) Talking about the effectiveness and the possible for harm, community water fluoridation increases some questions that are important although this is not surprising, although they are not limited to the issues of harm and benefit, policy makers of community water fluoridation are being provided with questions that are important about medication deprived of consent, individual choice being removed, are public water supply good delivery mechanism (Cheng, Chalmers and Sheldon,2007).
The Precautionary principle
This part will cover the the precautionary principle which is the justification of acting in the face of indecision, discovering a wide range of options to perhaps harmful actions, increasing public participation in making decision and moving the burden of proof to the proponents of an action. (Kriebel et al, .2001). The precautionary principle has been making known to recently into the international law and national law, including the European Union. One of its basics is the justification for acting in the face of indecision risks from environmental exposures. Public health actions should be taken in response to restricted, but reasonable and reliable, indication of expected and significant harm. (Grandjean, et al., 2004). However, Gabin et al., (2017) sighted that because the principle of protection and precautionary principle come into conflicts this makes health policy makers come into dilemmas. The effectiveness and necessity of scientific evidence is linked to the principle of protection, while the damages arising from a measure is associated with precaution. It can also be said that the principle of non- Maleficence can relate to water fluoridation, it can be seen as the principle by which harm or damage should not be inflicted to others (Beauchamp and Childress, 2002).The thing that frustrate those who support water fluoridation is that despite the benefit and cost there is always a controversy on how it is implemented. Like other public health issues water fluoridation has always been a public concern due to recent scientific evidence regarding that its harm is not documented (Armfield and Akers, 2009).
Mass medication without consent
Most people regard water fluoridation as medicine due o the fact that it reduces caries. While some of them says water, fluoridation is seen as a way of mass medications. While some people says it occurs naturally and it is therefore not seen as medicine, there must be a requirement from an approved authority if water fluoridation is viewed as medicine. (Cheng, Chalmers and Sheldon, 2007) However, Peckham and Awofeso (2014) argues that even though the use of fluoride for artificial water fluoridation is seen as medicine for the deterrence of tooth decay, for nations that implement artificial water fluoridation this is not subject to the firm guiding principle for medicines decrees. It is recommended that the means of preventing dental caries is the practice of water fluoridation. Even with this no country that fluoridates their water supply defines it as medicine, However, Cheng, Chalmers and Sheldon (2007) states that the strategies used to include fluoride to water supplies are often contentious. Potential benefits are related to controversy, Ethics of a mass intervention, difficulty of identifying harms, whether fluoride is a medicine. Furthermore Diesendorf (1995) also argues that even though fluoride is seen as a natural substance it does not take away the fact that it is seen as medicine.
Benefits and Harm
The branch of idea that explores conduct and decision making is called Ethics. (McNally and Downie, 2000). Ethically balancing the potential harm and benefit of all alternative requires sound healthcare policy making. Assessing the ethical rationality of the CDA procedure on water fluoridation therefore needs a deliberation of the likely benefits of harms of water fluoridation. (McNally and Downie, 2000). The greatest disease preventive measures and public health of all time known is water fluoridation. Most benefit of water fluoridation is that if the caries is reduced, the structure of the tooth is preserved, pain is reduced, and tooth loss, and restorative and infection treatments are prevented. (McNally and Downie, 2000).
However, McNally and Downie (2000) also states that potential harm of water fluoridation has raise concerns fluoridation can be the cause of increased fluorosis and this reason can be an argument not to support water fluoridation, it can also be seen as environmental pollution. If caries is reduced, water fluoridation will lessen the aim for restorative dental treatment thereby having a lifetime impact on oral health use and cost. This is a very significant benefit for Canadians because most of their health care services are not included in the health programs founded by the public. (McNally and Downie, 2000).it can also be said that Dental caries can cause life- threatening infections which can result in needing expensive medical care. Water fluoridation decreases the cost for those people like the children, seniors, and the poor whose healthcare includes dental care (McNally and Downie, 2000).
Infant and children between the ages of 6 months to 16 years benefit from Fluoride which plays a very important role for them, because primary and permanent teeth come in the oral cavity at this time, community water with fluoride in it helps in