Public attitudes concerning water fluoridation in Denmark

Fluoretação das águas de abastecimento público no Brasil: o olhar de lideranças de saúde

Desde sua implantação, a fluoretação das águas tem enfrentado oposição de alguns grupos, enquanto outros, baseados em evidência científica, apoiam a medida. Neste artigo, descrevem-se as percepções dos delegados à 13ª Conferência Nacional de Saúde sobre a obrigatoriedade da fluoretação das águas de abastecimento público no Brasil. Como técnica de processamento de depoimentos, utilizou-se o Discurso do Sujeito Coletivo. Constata-se que, mais do que dúvidas, persiste certo grau de desinformação sobre aspectos básicos da fluoretação das águas, frequentemente confundida com a cloração. Torna-se evidente também a necessidade de permanente divulgação à sociedade de dados sobre a fluoretação da água e o desejo de que medidas que afetam a saúde pública não sejam tomadas pelo Congresso Nacional sem que se ouçam os setores interessados. Conforme a percepção majoritária dos participantes deste estudo, a revogação da obrigatoriedade de fluoretar as águas ou deficiências no controle sanitário de sua aplicação poderiam, no contexto brasileiro, piorar os índices populacionais de cárie dentária.

Public opinions on community water fluoridation

BACKGROUND

Community water fluoridation (CWF) is currently experiencing social resistance in Canada. Petitions have been publicly registered, municipal plebiscites have occurred, and media attention is growing. There is now concern among policy leaders whether the practice is acceptable to Canadians. As a result, this study asks: What are public opinions on CWF?

METHODS

Data were collected in April 2008 from 1,005 Canadian adults by means of a national telephone interview survey using random digit dialling and computer-assisted telephone interview technology. Descriptive and bivariate and multivariate logistic regression analyses were undertaken.

RESULTS

Approximately 1 in 2 Canadian adults surveyed knew about CWF. Of these, 80% understood its intended use, approximately 60% believed that it was both safe and effective, and 62% supported the idea of having fluoride added to their local drinking water. Those with greater incomes [OR=1.4; p<0.001] and education [OR=1.6; p<0.001] were more likely to know about CWF. Those with greater incomes [OR=1.3; p<0.03] and those who visited the dentist more frequently [OR=1.8; p<0.002] were more likely to support CWF, and those with children [OR=0.5; p<0.02], those who accessed dental care using public insurance [OR=0.2; p<0.03], and those who avoided fluoride [OR=0.04; p<0.001] were less likely to support CWF.

CONCLUSION

It appears that Canadians still support CWF. In moving forward, policy leaders will need to attend to two distinct challenges: the influence of anti-fluoride sentiment, and the potential risks created by avoiding fluoride.

European citizens' opinions on water fluoridation

OBJECTIVES

To understand European citizens' opinions on water fluoridation, as part of research on their attitudes to the tensions between private and public interest.

METHODS

Sixty-eight focus groups held (with an average of eight people per group) in September and October 2003 in 16 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Poland, Portugal, Spain, Sweden and the UK).

RESULTS

Most participants were against water fluoridation, although groups in Greece, Ireland, Poland and Sweden were more in favour. Many felt dental health was an issue to be dealt with at the level of the individual, rather than a solution to be imposed en masse. While people accepted that some children were not encouraged to brush their teeth, they proposed other solutions to addressing these needs rather than having a solution of unproved safety imposed on them by public health authorities whom they did not fully trust. They did not see why they should accept potential side effects in order that a minority may benefit. In particular, water was something that should be kept as pure as possible, even though it was recognized that it already contains many additives.

CONCLUSIONS

While the vast majority of people opposed water fluoridation, this may be indicative of shifts away from public support of population interventions towards private interventions, as well as reduced trust in public agencies. Thus if research were to demonstrate more clear benefits of water fluoridation over and above that which can be achieved by use of fluoride toothpaste, then the public may become more supportive. However, lobby groups are likely to remain influential.