UK chief medical officers endorse water fluoridation
LONDON, UK: Though the benefits of fluoride in drinking water for oral health are firmly established, it is estimated that just six million UK residents have access to either artificially or naturally fluoridated water—less than 10% of the total population. A bill currently before the UK Parliament that proposes giving the Secretary of State for Health and Social Care “the power to directly introduce, vary or terminate water fluoridation schemes” in England and Wales has received the backing of Britain’s chief medical officers (CMOs), who have released a joint statement outlining the impact widespread fluoridation could have on dental caries.
Prof. Chris Whitty, Dr Gregor Smith, Dr Michael McBride and Dr Frank Atherton—the CMOs for England, Scotland, Northern Ireland and Wales, respectively—released a statement on 23 September in support of fluoride being added to community drinking water supplies. In their statement, they highlighted evidence that water fluoridation can significantly reduce hospital admissions related to tooth extraction. In addition, they pointed towards a report by Public Health England that showed that adding fluoride to water supplies containing low levels of fluoride would reduce the number of 5-year-olds with dental caries by 17% in the least deprived areas and 28% in the most deprived.
“There is unquestionably an issue with tooth decay in the UK and an entrenched inequality which needs to be addressed,” the CMOs wrote. “Fluoridation of water can reduce this common problem.”
They added: “On balance, there is strong scientific evidence that water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving dental health equality across the UK.”
According to the British Dental Association (BDA), modelling from Public Health England further indicates that the cost of widespread water fluoridation would be substantially outweighed by a reduced need for dental treatment, thereby effectively paying for itself.
“Every dentist will thank the CMOs for recognising the lasting benefits water fluoridation could bring to the nation’s oral health,” stated Dr Eddie Crouch, chair of the British Dental Association’s board.
“However, these gains are purely theoretical without upfront investment. Spending here will pay for itself, and ministers need to show they are willing to seize the moment,” he concluded.
CMOs ward off concerns
As the CMOs remarked in their statement, water fluoridation is a topic that “often attracts exaggerated and unevidenced statements that can cause unnecessary concern”. Though they noted that certain “weaker studies” claim an association between water fluoridation and medical conditions such as hip fractures, osteosarcoma and bladder cancer, they asserted that the evidence to support these contentions is conflicting. In conclusion, they stated that “prevailing public health opinion is now that there is no significant association between water fluoridation and these conditions”.