New plans for water fluoridation – reaction from the profession

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Calls are being made for better investment to support the government’s latest water fluoridation plans.

In a new white paper, the Secretary of State for Health, Matt Hancock, confirmed changes for significant NHS reforms.

This includes proposals to shift responsibility for water fluoridation schemes from local councils to central government.

One of the proposed moves would see the Health Secretary gain the power to ‘directly introduce, vary or terminate’ water fluoridation initiatives across England.

Financial backing necessary

But the British Dental Association (BDA) has warned that the new plans need to be propped up by capital investment.

It states that no new schemes have been introduced this century– despite the 2003 Water Act pledging to remove barriers.

Current laws dictating fluoridation means local councils have had to carry out lengthy public consultations and surveys, with no support from central government.

‘Fluoridation could be a game-changer, improving health outcomes while saving the NHS millions,’ said BDA chair Eddie Crouch.

‘Yet until we see up-front investment any benefits to public health or the public purse will remain purely theoretical.

‘Any commitment here can’t be at the expense of dental services and wider public health programmes, which have been badly hit by the pandemic. We need a joined-up approach to tackle deep health inequalities that now look set to widen.

‘Reforms will shape the way care is delivered, planned and regulated, areas where both patients and practitioners have been let down.

‘Ministers say it’s time to “build back better”, and that logic must be applied to dentistry.’

Effective public health measure

The Oral Health Foundation welcomes the proposals, saying the move will ease the process of water fluoridation for local communities.

Dr Nigel Carter OBE is chief executive of the Oral Health Foundation. He believes the plan will have a profound impact on the UK’s oral health.

‘In recent years we have seen water fluoridation proposals repeatedly stall at local authority level due to high cost, competing demands, and limited budgets,’ said Dr Carter.

‘All the while, tooth decay continues to be the most common chronic disease in the country.

‘Children’s oral health also continues to suffer. Tooth extractions, most of which caused by decay, remains the most common reason for hospital admissions of five to nine-year-olds in the UK. Yet this is a totally preventable disease.

‘Tooth decay comes at a tremendous cost to the economy. Around two million people in the UK have taken time of work in the last five years due to poor oral health. This was at a cost to businesses of more than £35m a year.

‘As a dental practitioner in Birmingham I saw first-hand the benefits to children’s oral health of water fluoridation. Working on the borders of fluoridated Birmingham and the then non-fluoridated Sandwell we could tell which side of the dividing road children came from based solely on their decay experience.

‘We believe that water fluoridation is the single most effective public health measure there is for reducing oral health inequalities. As well as tooth decay rates, especially amongst children.’

Flexibility is key

Similarly, the Association of Dental Groups (ADG) dubbed the plans a ‘significant moment’ for the future of the country’s oral health.

‘This is a significant moment as water fluoridation is probably the single most important step any government can take in protecting the country’s oral health,’ said Neil Carmichael, chair of the ADG.

‘It is widely accepted that water fluoridation is the most effective measure that can be taken to prevent dental disease.

‘Only a tenth of the UK has access to fluoridated water showing that the previous approach was not working. We welcome the proposals outlined today as a clear resolution by the government to take action on water fluoridation.

‘Moving a focus onto flexible commissioning and preventative measures is one way the government can limit and recover the damage to the nation’s oral health in the future.

‘Water fluoridation requires no behaviour change and the evidence shows it is highly effective. The next step must now be wider flexible commissioning of services to help those most in need.’


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