■ Re: Victor Luca’s “To fluoridate or not” opinion, Beacon, Feb 6, 2026; Dr Luca’s “murder house recollections” are familiar to those of us who attended primary school in the 1960s, writes Wainui resident Steve Clark.

It appears that the school dental nurse methodology of “prophylactic odontotomy”, a directive from the Department of Health, was the reason 1960s and early-1970s children were subjected to significant drilling and filling.

Prophylactic odontotomy involved deliberately drilling into and filling deep fissures (grooves or pits) in otherwise sound (non-carious) permanent molars as a preventive measure to stop potential future decay.

By the late 1960s to 1970s, surveys showed New Zealand children (including 12-13-year-olds) had “heavily-filled teeth” despite the School Dental Service and early fluoridation efforts.

Oral health surveys in the 1970s highlighted this, with high decayed, missing, filled teeth scores indicating extensive mercury amalgam restorations (mercury amalgam was the standard filling material then).

A notable decline began in the 1970s: Changes in preventive and restorative practices (eg, moving away from prophylactic odontotomy on sound fissures is reflected in a significant reduction in filled teeth (mostly mercury amalgam) with retrospective analyses showing a 64 percent reduction in fillings in some regions from 1976-1981.

It is noted that the amalgam fillings epidemic and the significant reduction in interventions that followed all occurred during the time when about 60 percent of the population on public water supplies had fluoridated water (per SDS historical reviews and Ministry of Health retrospectives).

Caries reductions occurred nationwide, including in unfluoridated regions, before and during the community water fluoridation rollout, which began with trials in 1954 and expanded in the 1960s-1970s, covering about 60 percent of the population by 1970.

There doesn't appear to be any rigorous way to disentangle the therapeutic impact of community water fluoridation from confounders like School Dental Service practices, other fluoride sources, and secular trends.

Dr Luca’s opinion includes a reference to the “UK Cochrane Report of 2024”.

I believe he is referring to The Cochrane Collaboration’s 2024 review on water fluoridation.

If so, the following statement from the Cochrane Collaborations press release is relevant to his opinion.

An updated Cochrane review has found that the dental health benefits of adding fluoride to drinking water may be smaller now than before fluoride toothpaste was widely available.”

The summary notes: “The benefits of fluoride in water supplies may be smaller than they were before the widespread addition of fluoride to toothpaste.”

The review explicitly notes that effect estimates (eg, for dmft reduction of ~0.24 fewer decayed teeth per child) include the possibility of benefit and no benefit, with confidence intervals crossing zero (eg, MD 0.24, 95% CI -0.03 to 0.52). Results indicate benefits but also “the possibility of little or no difference in tooth decay”. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010856.pub3/full.

Dr Luca advises people “who were concerned about being deprived of their right to choose” to install a point of use water filter capable of filtering out fluoride “that are not overly expensive”. An indication of expense is: Entry level between $235-$400 a year.

For comprehensive filtering capability (up to 98 percent) $1000-$2250 a year.

Given that the expense of water filtration is provoked by Whakatāne District Council’s water fluoridation policy, the water filtration cost to ratepayers should be met by the council and should be included in the cost effectiveness analysis of community water fluoridation.

Dr Luca identifies the people who could install filters as a group that “were concerned about being deprived of their right to choose”.

He does not include the 2000-plus people who rejected the proposal to put fluoride in the Whakatāne-Ōhope community water supply in the 2013 referendum.

This information may help inform those who are uncertain about the benefits of fluoridation that Dr Luca determines as being “clear” and for those who remain concerned about neurological impairment; even “at worst a potentially minuscule effect”.