ROTHERHAM Council has decided against putting fluoride in the borough’s water supply to improve the condition of children’s teeth, claiming there is insufficient evidence that it works.
The idea was strongly recommended by Rotherham Primary Care Trust, which said adding fluoride to tap- water can improve dental health and reduce decay.
But a review by the borough council concluded there was not enough evidence to back up the suggestion and said too much fluoride could have serious health implications.
In Rotherham’s most deprived wards the level of decay in five-year-olds’ teeth has missed both national and local targets, with only marginal improvement in the last 20 years.
The review heard the dental health of five-year-olds in the borough has not changed greatly since 1985; the vast majority are not treated, partly through reluctance; and fewer than half are registered with a dentist.
Rotherham PCT described fluoridation in a report as “the strongest evidence- based strategy for improved dental health, with greatest potential as a measure to reduce dental decay, particularly in children aged five and under”.
The Department of Health has supported the scheme since the early 1960s and about 10 per cent of the population receive fluoridated water from natural or artificial sources.
There is evidence fluoride in very small amounts strengthens growing teeth and helps them resist decay. Fluoride toothpaste has been widely used across the country for the last 30 years and appears to be a major factor in national dental health improvements.
However, councils in Sheffield, Leeds, Bradford and Calderdale have all rejected the idea.
A joint review was conducted by Rotherham Council scrutiny panels for Adult Services and Health and Children and Young People.
The panel agreed there was “an urgent need” to improve the dental health of the borough’s most disadvantaged communities in a way that “considers the effects on the population as a whole”.
It looked at whether adding fluoride to water effectively reduces dental decay in children and identified benefits and risks. Ethical implications of imposing a medical intervention on the public without the informed consent of those affected were also questioned.
Evidence that suggests too much fluoride can cause health problems, from minor cosmetic markings on the teeth to major skeletal deformities, was considered.
The review said that in tapwater “it would be impossible to control the amount of fluoride taken by each individual and ensure that each individual (whose ability to absorb fluoride may differ widely
from the next person) receives the optimum level and not too much.”
In 2001 the council cabinet supported a pilot project by the PCT to provide fluorid-ated milk to children at a primary school in Rawmarsh. The next year the scheme was extended to other areas in Rotherham. However, an evaluation into its effectiveness has yet to take place.
The panel concluded that while there is evidence of the benefits of artificial water fluoridation the long-term health and environmental impact “have not been sufficiently explored”.
It decided significant improvements to dental health could be achieved through other interventions.
And it said that although it “appears to be a cost-effect-ive way of reducing dental caries because of its universal effect, the cost of adding fluor-ide for the whole borough could be better spent improving the dental health of those communities in greatest need.”
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