Most residents of Southampton will have no choice but to receive fluoridated tap water if the South Central Strategic Health Authority agrees to the proposal. Its board is to make a decision on Thursday February 26 following a consultation.

While many health experts argue that adding fluoride will help improve children’s teeth, critics believe it is a coercive form of “mass medication” with unproven benefits.

If fluoride is added it will increase the concentration of the chemical in Southampton’s water twelvefold, from 0.08 parts per million (ppm) to one ppm.

Southampton Primary Care Trust believes this would “significantly improve the dental health of local people, particularly children”, in a city that has some of the worst dental health in the country.

Fluoride is added to most brands of toothpaste but those with poor dental habits consequently fail to benefit from it. Fluoride works principally by making teeth more resistant to decay: in fluoridated areas 15 per cent more children have “decay-free” teeth.

Barry Cockcroft, the chief dental officer for England, said it was “the perfect public health measure because people with the greatest need benefit most and most people benefit to some degree”.

But Stephen Peckham, a member of the pressure group Hampshire Against Fluoride, said there was “good evidence” to show it led to increased levels of fluoride-related tooth staining and other health problems die to “overexposure to fluoride”.

He added: “There has been no discussion of the complex ethical issues that water fluoridation entails.”

Should the proposal be successful it would be likely to increase pressure on other areas to follow suit.

Some six million of England’s 45 million residents receive fluoridated tap water – 5.5 million have it added to their supplies while 500,000 live in areas in which it occurs naturally.

Since 2003 health authorities have been able to order water companies to add it, rather than just ask.

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