Belgian ban does not cover toothpaste

With reference to Dr Joe Brincat's column ("Pasta, paste and pastizzi", The Sunday Times, August 4), the Malta Standards Authority would like to make the following clarification.

Contrary to what has been claimed in the article, the Belgian ban does not deal with the "sale of toothpaste" which "may be [of] hazard to health". The Belgian ban concerns only chewing gum, tablets and food products fortified with fluoride because the ban does not cover toothpaste, mouthwashes, dental floss or medication prescribed by health professionals.

Within the EU, the fluoride content of toothpaste and oral hygiene products such as mouthwash is already regulated by the Cosmetic Products Directive 76/768/EEC, which sets a maximum level of 0.15% fluoride content in such products. This provision has also been in force in Maltese legislation on cosmetic products since 2000.

Moreover, as yet, there are no EU provisions on the fortification of foodstuffs with fluoride or with any other nutrient.

Under European Law, in the absence of Community provisions, member states may introduce national legislation subject to the provisions of the EU Treaty which specifically permits national measures aimed at the protection of public health, provided that these measures can be justified on scientific grounds.

The matter may be referred to the relevant European Scientific Committee, which would carry out a risk assessment. This could eventually lead to the ban being extended across the whole of the European Union.

There is no evidence that the use of fluoride in toothpastes within the prescribed limits poses any danger to human health. On the other hand, the positive effect of low levels of fluoride in preventing tooth decay is widely accepted.

Some studies have however suggested that excessive consumption of high doses of fluoride may have negative effects on human health. In view of the need to avoid unnecessarily high exposures to fluoride, the fortification of foods with fluoride cannot be recommended.

Unlike cosmetic products, consumption of foods varies greatly between individuals and it may be impossible to ensure that consumers are not exposed to excessive levels of fluoride, particularly if a wide variety of foods are fortified.

It is for these reasons that Belgium could opt to ban the sale of foodstuffs or food supplements fortified with fluoride, but did not deal with products of oral hygiene or medication on prescription.

While hoping that this clarification explains the situation, should your readers have any further questions on the matter, they are kindly invited to contact the Malta Standards Authority on 2124-2420 or info@msa.org.mt.