The recent headlines that 12 per cent of three-year-olds across England have decaying teeth has already brought calls for water fluoridation to be extended further. Yet there is no evidence to demonstrate that adding fluoride to drinking water will prevent young children developing tooth decay.

While 10.8 percent of three year old children in Bedford have tooth decay, in fluoridated Wolverhampton the figure is 15.3 percent. In Bedford fluoridation is being re-introduced by Public Health England despite improvements in dental health having continued years after fluoridation ceased.

There is an alternative solution.

In Scotland the universal Child Smile scheme has dramatically reduced dental decay through a community based scheme that provides pre-school children with a simple daily supervised tooth brushing regime with extra support for children and their families, who have the worst decay.

The scheme is highly successful, but not only is the scheme effective, it tackles issues such as diet and nutrition and it is not costly.

Childsmile, which covers the whole of Scotland, costs £1.8 million a year and has been shown to save over £6million in treatment costs. Yet to fluoridate the West Midlands alone costs over £2 million plus the associated capital costs.

With restricted budgets it seems obvious which approach makes most sense.

Professor Stephen Peckham
Centre for Health Services Studies
University of Kent

*Note from FAN:

For a further understanding of the Scottish Childsmile program, which was created because of the Scottish Executive’s decision not to fluoridate, go to