The British Dental Association welcomed publication of a new review on the effectiveness of water fluoridation, stressing government has a responsibility to double down on tried and tested preventive programmes and restoring access to dental services.
The Cochrane Review – by academics at Universities of Manchester, Dundee and Aberdeen – say the establishment of Community Water Fluoridation (CWF) may lead to a slightly greater reduction in decayed baby teeth, and also lead to a slightly greater increase in the proportion of children who are free from decay. But it says the effect size is less than that demonstrated pre-1975, most likely due to widespread use of fluoride toothpaste since that date.
This review does conclude that CWF appears to offer good value for money due to its low delivery costs per head of population, potential to reduce decay, and dental treatment costs averted. It stresses every proposed scheme should be considered on a case-by-case basis according to population size, magnitude of potential benefit and the underlying prevalence of decay in the population served.
The new evidence on the reduction in effectiveness has not changed the BDA’s assessment that as a safe and effective public health intervention, CWF should form part of a package of measures to improve oral health, where technically feasible and appropriate for local needs. The professional body echoes the 2021 statement from the four UK Chief Medical Officers, which recognised water fluoridation should be seen as a complementary strategy, and not a substitute for regular dental check-ups and other effective methods of increasing fluoride use.
The BDA backs a joined-up approach in which tried and tested policies like water fluoridation and supervised tooth brushing in early years settings are expanded, with parallel effort applied to rebuilding access to high street dental services.
Around 5.8 million people in England receive fluoridated water, the lion’s share artificially added, but in some locations the appropriate level exists naturally within local water supplies.
Mick Armstrong, Chair of the British Dental Association’s Health and Science Committee said: “We have never pedalled silver bullets, or one size fits all solutions. What this new evidence shows is that water fluoridation has a role to play, as one of many tools in the fight against decay. Government needs to offer a joined-up response to close the nation’s oral health gap. “That means investing in tried-and-tested preventive programmes, while ensuring patients can access the care they need.”
