For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
The case for fluoride in water just got more complicated than you thought
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The case for fluoride in water just got more complicated than you thought
Monday 23 November 2020, 03:39 PM

Evidence on fluoride is of mixed quality, but an association with cognitive impairment complicates drinking water fluoridation
ANALYSIS
US toxicologists are taking a dimmer view of the risks of human exposure to fluoride. Jim Vause scrutinises their latest review for what it means for drinking-water policy and Kiwi children’s health
Key points, US experts report a moderate level of confidence in the evidence that higher levels of fluoridation (>1.5 parts per million) impact upon children’s ne
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
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References
- Health effects of water fluoridation: A review of the scientific evidence. Wellington: Royal Society of New Zealand and Office of the Prime Minister’s Chief Science Advisor; 2014. tinyurl.com/evidenceNZ
- Broadbent JM, Thomson WM, Moffitt TE, et al. Community water fluoridation and intelligence response. Am J Public Health 2015;105:3–4.
- Review of the benefits and costs of water fluoridation in New Zealand. Sapere Research Group; 2015. tinyurl.com/review-sapere
- Systematic review of fluoride exposure and neurodevelopmental and cognitive health effects, revised 16 September, 2020, is published by the Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, and US Department of Health and Human Services. The September 6, 2019 draft monograph was peer reviewed by a committee convened by the National Academy of Sciences, Engineering, and Medicine (NASEM). This current draft incorporates changes in response to that review and is being submitted to the same NASEM committee for an additional round of peer review. It can be found at: tinyurl. com/NTP-fluoride .The “Health (Fluoridation of Drinking Water) Amendment Bill” is available at: tinyurl.com/fluoro-bill