Tooth decay affects people at all stages of life and is the most common oral disease in children. In the school year of 2019, 23.4 percent of five-year-olds in England and 26.5 percent of P1 children in Scotland had experienced tooth decay. Tooth decay can significantly affect individuals’ general health and wellbeing but the UK Chief Medical Officers are about to deploy a UK-wide solution.
Fluoride is expected to be added to drinking water across the country after Britain’s chief medical officers concluded that the mineral would slash tooth decay rates.
Chris Whitty, the chief medical officer for England, and his counterparts in Wales, Scotland and Northern Ireland cited estimates by Public Health England that adding more fluoride to water supplies would reduce cavities by 17 percent among the richest children and 28 percent among the poorest.
They were quick to allay safety concerns, saying there is no evidence that ionised form of the element fluorine causes cancer and condemned “exaggerated and unevidenced” suggestions about health risks.
Evidence from observational and interventional studies shows that appropriate levels of fluoride can reduce the prevalence and severity of dental decay in both adults and children.
The medical officers issued their verdict in an evidence review on Thursday: “As with all things in medicine and public health there is a balance of risk and benefit.
“There is unquestionably an issue with tooth decay in the UK and an entrenched inequality which needs to be addressed. Fluoridation of water can reduce this common problem.
“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. It should be seen as a complementary strategy, not a substitute for other effective methods of increasing fluoride use.”
A report by Public Health England found that water fluoridation can substantially reduce hospital admissions for tooth extraction. If all five-year-olds with drinking water with less than 0.2 mg/l fluoride instead received at least 0.7mg/l from a fluoridation scheme, then the number experiencing caries would be lower.
The decline would be 17 percent in the least deprived areas, rising to 28 percent in the most deprived, and the number of hospital admissions for tooth extractions in children and young people is estimated to reduce by 45 to 68 percent.
What is fluoride and does it carry any risks?
Fluoride is a naturally occurring mineral found in water and some foods. The amount of naturally occurring fluoride in water varies across the UK due to geological differences.
Water fluoridation schemes involve adding fluoride to community drinking water supplies in areas of low natural fluoride, increasing the level to that known to reduce tooth decay.
According to the medical officer’s statement, water fluoridation is not a substitute for good oral hygiene, regular dental check-ups and limiting sugar intake but it has an effect even when those are absent.
There are other effective methods for getting fluoride onto teeth.
“It is added to most toothpastes and can be applied as a fluoride varnish by a dental professional,” according to the medical officer’s statement.
In Scotland, Wales and Northern Ireland, daily supervised tooth brushing schemes take place in early years and primary school settings.
“These approaches can all help to protect teeth against decay, however, water fluoridation schemes can be advantageous as they do not require population behaviour change,” it states.
Javid tweeted a link to the chief medical officer’s conclusions and wrote: “Good to see UK CMOs examining how water fluoridation can improve oral health & prevent tooth decay which disproportionately affects more deprived groups. Reinforces why our health and care bill will make it simpler to expand water fluoridation schemes.”
The British Dental Association (BDA) also expressed its approval at the statement from the four UK chief medical officers.
Eddie Crouch, the BDA chair, said: “Every dentist will thank the CMOs for recognising the lasting benefits water fluoridation could bring to the nation’s oral health.
“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. We need a joined-up approach. Covid has left millions unable to access care, and deep inequalities are now set to widen.”