Southampton is to forge ahead with plans to add fluoride to its tap water, despite protests.
The final decision was made at a meeting of the South Central Strategic Health Authority (SHA) following three months of public consultation in Southampton and parts of south-west Hampshire.
It makes Southampton the first place in England to introduce fluoridation since Health Minister Alan Johnson’s ‘fluoridation for all’ proposal in February 2008.
The special meeting, held at the city’s St Mary’s stadium, attracted representatives from both sides of the fluoridation argument, including chief dental officer Barry Cockcroft, representatives from the British Dental Association (BDA), MPs, members of pressure group, Hampshire Against Fluoridation, and other anti-fluoride campaigners.
The plans had been put forward in a bid to improve the city’s poor record on dental health in children, particularly in more deprived areas.
The decision comes after the public consultation in which more than 10,000 people had their say.
More than seven out of ten of all respondents who live in the affected area said they were against the plans, while an independent phone survey also showed more people against the scheme than for it.
But Southampton City Primary Care Trust (PCT), who made the proposals, said that the public vote could not be the deciding factor and that medical evidence shows fluoridation will reduce tooth decay – and failed to back up claims of serious negative side effects.
The PCT also says other measures to beat tooth decay have not worked, and fluoridation is the most effective method left available.
A Department of Health spokesman welcomes the decision. He said: ‘We believe that fluoridation is a scientifically supported and effective means of addressing health inequalities by reducing tooth decay in children and adults, especially those from poorer backgrounds.
South Central Strategic Health Authority’s decision on fluoridation has been made following a 14-week consultation, during which the views of local people were listened to, and taking into account medical evidence and the oral health needs of the people of Southampton, Eastleigh, Totton and Netley.’
The British Dental Association also welcomed the move. BDA scientific adviser, Professor Damien Walmsley, said: ‘The BDA commends South Central’s decision as we believe that fluoridation is a safe and effective method of reducing dental decay and oral health inequalities. The significance of today’s decision is not confined to the people it will affect directly. Other SHAs in England have been waiting to see if South Central – as the first SHA to consult on fluoridation since the law changed in 2003 – would succeed before launching their own consultation.’
Now the decision has been approved by the SHA’s board, the amount of fluoride in the water will be increased from 0.08 parts per million to one part per million by 2010 at the earliest. The SHA will enter legal negotiations with Southern Water to determine how the process will be carried out and how much it will cost.
The forces ranged against the plans included Hampshire Against Fluoridation, Hampshire County Council and local Liberal Democrat MPs Sandra Gidley (Romsey) and Chris Huhne (Eastleigh).
MP Sandra Gidley said: ‘The board members have got this completely wrong and have chosen to ride roughshod over the overwhelming opinion of the public. Whilst there is a lot of research on the subject of water fluoridation, much of it – like the board’s judgement – is sub-standard. It would be far cheaper and more effective to provide toothpaste and brushes to those who can’t afford it rather than introducing a mass medication programme.’
Stephen Peckham, a member of Hampshire Against Fluoridation and a reader in health policy at the London School of Hygiene and Tropical Medicine, added to the argument against the plans.
He said: ‘Clearly, the SHA officers are determined that fluoridation should go ahead whatever. The York Review authors point out that there is no evidence to demonstrate that water fluoridation reduces inequalities. Neither is there any evidence to demonstrate that at the historically low levels of dental decay in the majority of children (12 year old rates are better than the UK average) water fluoridation will have any effect. Yet water fluoridation will cause an increase in dental fluorosis with children requiring repeated remedial treatment.
He added: ‘This decision to implement water fluoridation in Southampton is not evidence based, safe or ethical.’
Other proposals for fluoridation are in the pipeline elsewhere in the country – including Manchester – but officials were believed to be watching developments in Southampton before committing to the consultation process.