Public opinion on community water fluoridation in Scotland.

Sir, a random on-street survey of 410 people resident in three urban areas in Scotland (Aberdeen, Edinburgh and Glasgow) in 2021 showed that 63% thought fluoride should be added to water if it can reduce tooth decay, 28% stated they didn’t know and 9% opposed the fluoridation of their water supply.¹

The two largest health boards in Scotland (NHS Greater Glasgow and Clyde and NHS Lothian) have recently reported the findings of their local health surveys which included a question on water fluoridation (Box 1).^2,3

The Health and Wellbeing Survey was conducted through face-to-face interviews with 10,030 adult residents across the NHS Greater Glasgow and Clyde between September 2022 and May 2023. The responses to the statement ‘I am open to the possibility of water fluoridation in my local area’ are shown in Fig. 1.²

Responses to the statement ‘I am open to the possibility of water fluoridation in my local area’

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Those with a limiting condition/illness were less likely than others to be open to the possibility of water fluoridation, as shown in Fig. 2.²

Responses to the statement ‘I am open to the possibility of water fluoridation in my local area’ by limiting conditions

The water fluoridation question was the subject of a complaint from a respondent in Lothian who felt that the question was leading as the beneficial case for water fluoridation was presented before the question itself: ‘There is strong recent evidence and support from UK Chief Medical Officers that adding fluoride to water supplies will help reduce tooth decay’. Additionally, the ‘Don’t know what water fluoridation is’ answer category could have included the additional text ‘or enough about the subject’. As the design of the questionnaire item may have led to biased results, this question was excluded from the summary report.³

Based on the above findings, it will be challenging to introduce community water fluoridation in Scotland.