Serious about water fluoridation?

Water fluoridation is an issue, like amalgam, that seems to have been with us for ever.

Certainly, it has been on and off a live issue, since I went up to dental school 50 years ago.

The only major schemes to have been implemented have been in the West Midlands.

In total, around four million across the country now drink artificially fluoridated water.

A proposal to introduce the measure in Southampton has been beset by legal challenges and a vociferous pressure group, Hampshire against Fluoridation.

There has been little progress in North West England despite its having high caries levels.

In Scotland, the issue has been dead since a landmark legal case which lasted 201 days. On 29 June 1983, Lord Jauncey ruled that a proposal to fluoridate water for the purpose of reducing tooth decay was illegal (ultra vires).

The message behind this slow progress since the UK trials were completed in 1960 is that, although surveys confirm that many of the public support the measure, at local level those opposed to it are singularly successful in delaying or preventing its implementation.

Its relevance today is that from April 2013, decisions on public health, including fluoridation, pass to local authorities. Strategic Health Authorities (SHAs), which currently initiate schemes, will be abolished then.

Already all three parties on Southampton city council say they will oppose fluoridating the water supply. Some councils, notably in the West Midlands, do support the measure, but this is not true in many other areas,

Last week, the Department of Health issued a consultation document outlining the process for implementation when SHAs go and approval is down to local authorities. The government believes they are ‘best placed’ to make a decision on behalf of their local population.

The consultation document is a lengthy one covering not only the decision of whether to fluoridate, but the membership of committees advising the local authority and its working procedures.

The Department says it is not consulting on ‘the perceived benefits or disadvantages of fluoridation’, but the process by which decisions are to be made.

This is hardly a ringing endorsement of water fluoridation, which many believe is an essential public health measure if the dental health of children in socially deprived areas is to be improved.

The Coalition agreement pledges to focus on ‘achieving good dental health with an additional focus on the oral health of schoolchildren’.

Handing water fluoridation over to local authorities, influenced against the measure by vocal pressure groups, is not the way to achieve their objective.

Michael Watson, Dentistry news correspondent

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