“Primary care trusts are responsible for assessing the oral health needs of their population and for commissioning services or interventions required to improve oral health.

In discharging this duty, PCTs have been encouraged by the chief dental officer to consider the option of fluoridating their water supplies.

Water fluoridation is the process of artificially topping up the natural fluoride in water to the level at which it can help to reduce tooth decay.

The most recent comprehensive review of the scientific studies carried out to assess the effects of water fluoridation was completed by the University of York.

The York Reviewers were able to conclude that the best available evidence suggests that fluoridation of drinking water supplies reduces the number of people affected by tooth decay and the average number of teeth affected by tooth decay.

Considering potential harms, the York Review found no clear association between water fluoridation and incidence or mortality of bone cancers, thyroid cancer or all cancers.

The reviewers highlighted the association between water fluoridation and dental fluorosis.

Dental fluorosis is a form of defect of tooth enamel, which appears as markings on the surfaces of teeth. At the levels of fluoride used in water fluoridation the prevalence of noticeable objectionable fluorosis was estimated at 12.5 per cent.

Around 10 per cent of the country already receives water which is fluoridated most notably in the West Midlands area where there are demonstrable benefits and no evidence of other harms.

Parts of West Cumbria also normally receive fluoridated water from schemes introduced in the late 1960s and early 70s.

From a scientific point of view, the evidence suggests that water fluoridation will provide health benefit with minimal risk.

However before any new water fluoridation schemes are introduced it is vitally important that those affected are consulted about the proposals as since this is a public health measure rather than an individual one there is no opportunity for individual consent.

Regulations made following the 2003 Water Act ensure that those affected by any proposal to fluoridate the water supply are consulted.

The PCTs and the Northwest Strategic Health Authority are considering a preliminary document outlining the potential to use water fluoridation as a means to improving the oral health of our population in the North West.”

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