The Welsh Government’s failure to fluoridate water supplies brings into question its commitment to improving the dental health of the nation, according to the chairman of its advisory body.
The National Oral Health Plan for Wales, published by the Welsh Government last Monday, states that 41% of children in Wales have four teeth decayed, filled or extracted by the age of five.
The plan sets out how oral health will be improved and inequalities reduced over the next five years, but reiterates the Welsh Government’s long-held policy not to add fluoride to water supplies.
Responses to the draft plan’s public consultation shows more than a dozen of the 61 respondents – including health boards and dental organisations – called for fluoridation.
Karl Bishop, chairman of the Welsh Dental Committee, wrote: “The failure to plan to fluoridate water supplies on account of ‘the fact there are small groups of people opposed to it’ is abdicating responsibility for a cost effective way of reducing dental caries which is extremely disappointing and questions the WG (Welsh Government) commitment to improving the dental health of the nation.”
Gill Richardson, director of public health at Aneurin Bevan Health Board, which covers Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen, said: “Denying children fluoridated water denies them an intervention as effective as immunisation”.
She said fluoridation would in time mean savings in resource as the Welsh Government’s Designed to Smile programme, which has involved more than 78,000 children since 2009, would no longer be necessary.
Morgannwg Local Dental Committee, which represents dentists in Bridgend, Neath Port Talbot and Swansea, said water fluoridation – which it described as “the single proven most effective measure to reduce tooth decay in children, particularly vulnerable children – had “only been paid lip service”.
It said the Welsh Government should follow the lead of the Department of Health which is consulting on water fluoridation in England, adding: “If the Welsh Government is serious about promoting good dental health then it has to address the difficult decision making in relation to water fluoridation.”
Cardiff and Vale University Health Board deputy chief executive Paul Hollard wrote: “Water fluoridation is too conveniently and quickly brushed aside within the plan.
Water fluoridation reduces the inequalities in dental health associated with material and social deprivation and is the most cost-effective preventive strategy for reducing dental caries to all residents of a community.”
Betsi Cadwaladr University Health Board, Hywel Dda Community Health Council and Cwm Taf Health Board also all wrote about the benefits of fluoridation and called for the policy to be reviewed.
British Medical Association (BMA) Cymru Wales said proposals in the plan were “extremely unlikely to be enough to meet the minister’s main objective – unless fluoridation of water supplies is introduced in parts of Wales, after meaningful public consultation”.
It said a survey in 2008 showed children in some of the most deprived areas of the West Midlands, where 3.7 million people receive fluoridated water, enjoy some of the best oral health in the UK.
Fluoridation was introduced on Anglesey in 1964, where the levels of tooth decay amongst children was half that of those on mainland Gwynedd, the BMA added, but oral health has declined since it was halted in 1992.
“Our view is that unless fluoridation of water supplies is introduced the dramatic improvements achieved in the West Midlands, the Republic of Ireland and achieved in the past in Gwynedd will not be replicated in Wales,” the BMA response states.
A Welsh Government spokesman said: “There are no current plans to fluoridate water supplies in Wales, but we will keep the matter under review.”
Opposition parties backed the stance, with the Welsh Liberal Democrats saying: “There is no such thing as absolute certainty when it comes to health safety – but in normal circumstances patients can weigh up the pros and cons of receiving potentially risky treatment and choose whether to undertake it. Mass fluoridation of water would leave people with no choice, and we believe that it should not be imposed by central government.”
A spokesman for the Welsh Conservatives added: “We are opposed to compulsory fluoridation as the potential detrimental effects outweigh the benefits to oral health. Instead, the Welsh Government should take steps to improve access for children and adults to regular NHS dental checks, which could significantly improve oral health.”