The British Dental Association (BDA) has echoed concerns expressed by the British Society of Paediatric Dentistry (BSPD) that limited access to water fluoridation – 10% of the UK’s population – means we are failing children who live in communities with high levels of tooth decay.
The BSPD highlights in its latest report on fluoridation that 60,683 children and adolescents in England were admitted to hospital in 2012/13 to have multiple decayed teeth removed under general anaesthetic, costing the NHS at least £27.6 million.
By contrast, evidence suggests that children living in fluoridated areas, such as the West Midlands, have around half the rate of tooth decay of those living in non-fluoridated areas.
The BDA’s scientific adviser, Professor Damien Walmsley, said: ‘Water fluoridation is safe and is one of the cheapest and most effective measures to reduce unacceptable inequalities of tooth decay, yet public debate on this is often reduced to misinformation and scaremongering with little or no regard to the communities affected most by this largely preventable disease.’
Despite the improvements in the oral health of children in areas where water is fluoridated, the BDA questions why a fluoridation scheme was recently abandoned in Southampton after being endorsed by Public Health England and a high court ruling that the process in recommending water fluoridation had been lawful.
The BDA is also concerned that water fluoridation was excluded from the NICE recommendations (published last month) for local authorities to consider when tackling high levels dental disease in their population.
The BDA believes that ‘political and clinical leaders should ensure that dental health policies are driven by the available evidence, rather than pandering to misinformation and fear’.
The chair of the BDA’s General Dental Practice Committee, John Milne, said: ‘My practice is based in one of the most deprived areas in Yorkshire, and it’s frankly heart breaking to have to refer young children to hospital to have several decayed teeth removed under a general anaesthetic when I see the dramatic improvements in dental health in areas that are fluoridated.
‘Local authorities with a high prevalence of tooth decay in their communities should be able to consider water fluoridation, if advised to do so by their experts in dental public health, but as the BSPD has noted, NICE wasn’t bold enough to include this in its recent guide on measures to reduce tooth decay.
‘What kind of message does that signal to politicians and experts in dental health?
‘Critics of fluoridation often say that tooth brushing schemes in nurseries and schools are the answer.
‘Whilst these may be part of the solution, they are resource-intensive, require parental consent and don’t always reach those communities with the highest need, as we know from the fact that one in eight of our three-year olds have tooth decay.’