Wrexham AM Lesley Griffiths has called for the National Assembly to debate whether fluoride should be added to the Welsh water supply. But will such a form of mass medication improve our dental health?
Dr Richard Lewis, Welsh Secretary of the British Medical Association, puts forward the case for flouridation
THE BMA has for many years been in favour of the fluoridation of mains water supplies. We support this policy on the grounds of effectiveness, safety and equity.
Section 58 of the Water Act 2003 makes it mandatory on water companies to fluoridate supplies wherever this is formally requested by health bodies, following full and proper consultation with local communities.
This will give local populations the right to choose to have their water fluoridated.
Fluoridation of water is an effective public health strategy for reducing tooth decay in the population.
The evidence accumulated over many years shows fluoride is highly protective to the teeth of children, and is very safe. Water fluoridation is one of the most effective ways of reducing tooth decay in the community.
Not only does water fluoridation reduce tooth decay and consequently the number of extractions needed, but it also brings the added and welcome benefit of a reduction in the number of general anaesthetics administered to children.
The BMA believes there is no convincing evidence of any adverse risk to human health by the introduction of water fluoridation.
Evidence through scientific studies shows that fluoride in water, at or around one part per million, does not have any effect on the health of the body other than reducing decay in teeth.
This view is supported by the World Health Organisation, the Royal College of Physicians, and the British Dental Association, among others.
There is more than 40 years of experience in England of artificial fluoridation and we are not aware of evidence of harm demonstrated in those areas, other than dental fluorosis in a small number of children.
Neither the York review nor the MRC working group could find convincing evidence of musculoskeletal disease, kidney disease, infertility, central nervous system damage or damage in the thyroid gland.
Tooth decay is a significant problem in the UK, particularly in socially deprived areas. Dental health inequalities are widening and severe tooth decay is associated with child poverty.
Children from less well-off backgrounds may have five times more tooth decay than those in the highest social classes.
Studies have shown that children in non-fluoridated under-privileged areas of the UK are more likely to have teeth extracted due to tooth decay than those in either affluent, or similar, but fluoridated areas.
For example, five-year-olds in non-fluoridated Manchester suffer almost two-and-a-half times more tooth decay than those in fluoridated Birmingham and almost three times more than their peers in affluent West Surrey.
A few miles from Birmingham is Sandwell – one of the most socially-deprived districts in the country. Thanks to water fluoridation, the dental health of young children in Sandwell is excellent.
Many more children and adults in this country would have deficiencies in various basic nutrients but for food fortification regulations.
We have no concerns about the mandatory addition of vitamins A and D to margarine, and calcium, iron, thiamin and niacin to most types of flour, or the voluntary fortification of common types of food such as breakfast cereals and baby foods. Water fluoridation is simply the fortification of fluoride- deficient water supplies, and should be treated no differently.