NORTH EAST BYLINES (HEALTH). Water fluoridation started in the North East and we are now on the brink of new schemes to exorcise rampant dental decay in the region

Once again the North East leads the way. If all goes well, many more people will eventually have better teeth when new water fluoridation schemes are implemented. Already well supplied with fluoridated water (and benefitting greatly), the additional supplies, which fill in the gaps left from the 1960s, will complete the coverage of the North East once implementation takes place over the next few years and after an imminent period of consultation.

The history of water fluoridation

Some say the North East invented the fluoridation of water to prevent dental decay. You can trace its history right back to 1831 when cholera arrived by ship. Once it was endemic and in the water, South Shields decided it didn’t want the infected supplies it used to get from Sunderland, so it dug wells and extracted clean water.

During the Second World War, children from North and South Tyneside were evacuated to the Lake District to avoid the bombing of Tyneside shipyards.

While there, local dentists found that there was a marked difference in the teeth of the children: those from South Tyneside had much better teeth than those from North Tyneside. On investigation, it proved that the water used from the wells south of the Tyne was naturally fluoridated (because of the rocks the wells were drilled into) whereas North Tyneside water was unfluoridated (It was mainly surface water).

So adding small quantities of fluoride to drinking water (mimicking nature) was developed and spread around the world. The North East formally adopted this preventive measure widely in the 1960s and the current plans take the job to completion. New legislation will also allow the intervention to be implemented in the rest of England where it is needed and rational to do it (for example, where the water supply is amenable, where there is poor dental health, and where economies of scale exist).

The benefits of water fluoridation

Water fluoridation is one of the few tools that reduces both overall disease levels and inequalities. Just about every bit of decay in a permanent tooth will end up needing treatment, and every restorative treatment will be redone several times in that person’s life, with that treatment increasing in complexity and expense every time. Most dental treatments (root canal therapies, crowns, implants, dentures and so on) start with decay. If we prevent even one carious lesion, we can prevent a whole lifetime of complex dentistry, saving a fortune, not to mention reducing pain, discomfort and distress. And the measured reductions in decay occur over only a few years. Fluoridation reduces caries over a lifetime, as well as the repeated treatment consequences of each attack of decay.

From one dentist in the North East

This power of fluoride to reduce dental decay is reflected in the personal experiences of dentists practising today. One dentist from North East England experiences both fluoridated and non-fluoridated areas in his everyday work:

“I work in a general dental practice in a northwestern area of the North East, which has an artificially adjusted fluoride level. The patients that I see every day have had the benefit of fluoride in their water supply. But I also work in urgent care across County Durham and in Sunderland, and I see the effects that not having fluoride and how that impacts populations in those areas.

“Patients who come in to see me in my northwestern practice generally most commonly have no experience of dental disease in children at all. They are fit and well, and they have no dental disease. They have no experience of dental pain. They’ve had no experience of dental treatments. And the vast majority of my patients are like that. Occasionally, when I do get patients that have some dental decay, is tends to be very slowly progressing and is restricted in terms of its size and spread.

“Compare that situation to some of the unfortunate sites that I see in both Central Durham and in Sunderland Royal Hospital with the urgent care service, where we see rampant or extensive tooth decay, so much so that the teeth are destroyed and they all need to be removed. It’s an absolute tragedy that we see children with such devastation to their young teeth and the trauma and the pain that this produces for these individuals is just absolutely immeasurable. And of course, it impacts not only the children but upon the parents who then have the guilt because of the pain and suffering. And of course, often having to go through general anaesthesia to have these teeth removed. So it impacts not only upon the children themselves but also upon the families. The fluoridation of the water supply doesn’t eliminate tooth decay, but it significantly reduces it to such a great degree that the pain and suffering and trauma that these families have every day is much reduced”.

The new schemes

It’s not just a clinical issue, where healthcare staff still see how well it works in their surgeries. It is also popular with the public. In a recent survey in the North East, most people supported water fluoridation.

We are now on the brink of exorcising rampant dental decay in the North East when the new schemes come online. The intervention was developed here, has been tried and tested here (for efficacy, safety, acceptability, and desirability) and may finally be bottomed out locally. Please support the issue when the consultation takes place.

For more information, facts and figures and technical details go to the British Fluoridation website; and for government:.

Ray Lowry, a qualified doctor and dentist, completed formal training in public health and became an NHS consultant in 1990. Until he retired in 2010 he was a senior lecturer in dental public health at the University of Newcastle upon Tyne and a Fellow of the Faculty of Public Health. He is secretary/treasurer of the British Fluoridation Society.