Children living in greatest deprivation have most to gain from having a fluoridated drinking water supply, according to new research. Fluoride is added to water in order to prevent tooth decay and the new study demonstrates that community water fluoridation is particularly beneficial for the youngest children in the poorest communities.
The research was carried out in New Zealand and published in the International Journal of Epidemiology. It adds to the body of research demonstrating that community water fluoridation (CWF) reduces dental health inequalities. The key findings of the research are:
- Children from the most deprived areas are more likely to be admitted to hospital for the treatment of pain or sepsis (abscesses) caused by dental decay
- Fluoridation of the water supply reduces the number of children being admitted to hospital for dental extractions under a general anaesthetic
- The youngest children in the 0-4 age category in the most deprived areas benefit most from water fluoridation
In New Zealand, around 60% of the population benefits from fluoridated water, mostly city-dwellers. The team from the University of Canterbury in Christchurch compared the number of hospital visits of children in 0-4 and 5-12 age categories from both fluoridated and non-fluoridated areas.
Professor Mike Lennon, a member of the British Fluoridation Society’s executive, said: “This paper shows the evidence supporting the benefits of fluoride in drinking water is getting stronger. It demonstrates that you can reduce the risk of negative dental experiences for children from poor homes. Without fluoride in the water, they are more likely to end up in hospital with toothache.”
The role of water fluoridation in reducing health inequalities was identified in the UK in the University of York Systematic Review of 2000. Since then, the evidence base has continued to grow with more research undertaken in the UK as well as Israel, Korea and Australia.
Professor Lennon said the data collected by the team from the University of Canterbury had been rigorously analysed. Their focus was ambulatory sensitive hospitalisation (ASH) which are hospital outpatient admissions for preventable conditions, in this instance for tooth decay and infection.
Comparisons were carried out between different census areas and then adjusted for factors which could negatively influence the result, such as living miles away from a dental practice. The overall conclusion of the study is: “As deprived areas have the highest incidence of dental ASH, caries and poor oral health, those who live in the most deprived areas have the most to gain from CWF. In summary, our study supports evidence linking CWF to better health in children. Variation in CWF contributes to structural inequities in oral-health outcomes for children.”
Simon Hearnshaw, the Chair of the Local Dental Network for North Yorkshire and Humber and coordinator of the National Community Water Fluoridation Network, welcomed the research, saying: “This paper provides more support for the argument that fluoridation is effective and reduces the social-health gradient. The challenge now is to implement schemes to bring these important benefits to deprived communities.”
The latest research is entitled: Area-level deprivation, childhood dental ambulatory sensitive hospitalizations and community water fluoridation: evidence from New Zealand https://doi.org/10.1093/ije/dyaa043