The British Society of Paediatric Dentistry (BSPD) is unequivocally supportive of fluoridation of water as a public health measure in areas where it is needed. The Society has issued a position statement under the guidance of one of the UK’s foremost authorities on the subject, Professor Emeritus Andrew Rugg-Gunn. http://www.bspd.co.uk/Default.aspx?tabid=140
The statement advocates the fluoridation of drinking water as a public health measure and harnesses research from around the world. The evidence demonstrates that the benefits to dental health have been overwhelmingly positive for more than 50 years.
It also highlights that only 10 per cent of the UK currently benefit from fluoridated water and this contributes to the high levels of decay seen in some areas as well as hospital admissions and general anaesthetics for multiple extractions in children as young as three years of age.
The BSPD statement highlights the following key facts:
- Water fluoridation was first introduced as a public health measure more than 70 years ago and now exists in 25 countries, with over 444 million people worldwide drinking water with an optimum concentration of fluoride.
- The World Health Organization has consistently found water fluoridation to be safe and effective. The International Association for Dental Research has also consistently supported this measure.
- The success of early trials of water fluoridation following the Second World War resulted in fluoride being added to toothpaste and mouthwash leading to substantial oral health improvements worldwide.
- Among the leading figures and professional organisations who support water fluoridation are: the chief dental officer for England, Barry Cockcroft, the British Dental Association, Public Health England, the Faculty of Public Health of the Royal Colleges of Physicians of the UK and the British Medical Association.
- Support has come from across the political spectrum, with facilitating legislation having been introduced over the past thirty years by Conservative and Labour health ministers.
- Between around two thirds and three quarters of respondents in many UK national and regional opinion surveys conducted over that period thought fluoride should be added to water if it can reduce tooth decay.
The BSPD position statement concludes: “The British Society of Paediatric Dentistry supports the fluoridation of public water supplies in communities where the burden of dental decay is severe enough to warrant this public health measure and fluoridation is technically feasible.”
But set against this overwhelmingly positive and evidence-based support for water fluoridation is the vocal opposition of a small minority of people. Last month, Public Health England announced it would not proceed with water fluoridation in Southampton as a result of opposition to a local scheme proposed in 2008. This is despite Public Health England endorsing the measure and a High Court ruling that the process in recommending water fluoridation had been lawful. It is currently unclear how Southampton City Council plans to reduce dental decay amongst the local population.
Claire Stevens, a consultant in Paediatric Dentistry and BSPD spokesperson said: “Water fluoridation is the most cost-effective and equitable way for children to benefit from the protective effect of fluoride. It can also be applied as a varnish directly to teeth and is now available in most children’s’ toothpastes but both these measures require the intervention of a parent or a dentist and so won’t necessarily benefit the group who most need our support, children in deprived communities.”
She continued: “A recent report from Public Health England showed that 45 per cent fewer children aged one to four living in fluoridated areas are admitted to hospital for tooth decay than in non-fluoridated areas. Many children who live in deprived communities do not have fluoride in their water. Put simply, we are failing those who most need society’s support. In the 21st century, this is regressive.”
Claire said: “We are concerned that the majority of people in the UK miss out on the proven benefits of water fluoridation because of a scaremongering campaign which is not based on evidence.”
Claire added that BSPD was supportive of the most recent guidance from the National Institute of Clinical and Healthcare Excellence (NICE) - http://www.nice.org.uk/guidance/ph55 - which reflected a new mood of responsibility for the oral health of young people, particularly those in disadvantaged areas.
She added: “In an ideal world, the NICE guidance would have gone further and recommended a national water fluoridation programme in areas of highest need. It feels as if no one wants to be bold enough to challenge those opposing fluoridation but all of us in healthcare have a duty to reduce inequalities. Water fluoridation has created a postcode lottery which is failing thousands of children annually.”