ANNEX IV: FLUORIDATION
258. Oral health is an area in which significant
inequalities exist. One seemingly straightforward and effective
way of remedying oral health problems is to fluoridate the water
supply. The results of this have been seen in Sandwell, where
the water supply was fluoridated in 1986. Between 1986-96, the
amount of tooth decay in children more than halved in the area.
During the same period, there was little change in the oral health
of children living in Bolton, an area with a similar population
mix to Sandwell but without fluoridated water.[351]
259. We have received many calls from witnesses and
in oral evidence for the fluoridation of water supplies. There
is also, however, a vociferous group opposed to such action. The
action taken by the Government has been to commission a review
of the available evidence on the relationship between fluoride
and health from the NHS Centre for Reviews and Dissemination at
the University of York The report of this review was published
in October 2000, and its conclusions were that, although the available
evidence confirms that fluoridation helps to reduce tooth decay,
albeit with the possible cosmetic side effect of dental fluorosis,
there remains a need for further good quality research.
260. The Government's response to the York review
was to ask the Medical Research Council to assess what further
research was needed. The MRC has provisionally agreed terms of
reference stating that it should provide advice on current scientific
evidence on the health effects of water fluoridation, and consider
whether further research in this area is required to inform public
health policy.[352]
This seems rather like a duplication of the work of the York review,
but the need to pursue the research issue further before the Government
can make a conclusive decision is obvious.
261. A further barrier to fluoridation exists in
the legislative framework which governs the local implementation
of fluoridation. Although a health authority may ask a water provider
to fluoridate the water supply, and indeed since the Water Fluoridation
Act 1985, over half of all health authorities have done so, the
final decision to take action rests with the water provider. None
of the requests made since 1985 have resulted in action on the
part of water companies. Should fluoridation be deemed to be acceptable,
in the light of further evidence, the Government may have to revisit
legislation to force the companies to act, perhaps allowing for
local ballots. When giving evidence to the Committee's inquiry
into Access to NHS Dentistry, Lord Hunt told the Committee that
he has started a process of meetings with the water companies
to see to what extent they would be prepared to agree to new schemes
to introduce fluoridation.[353]
351
Official Report, 29.1.2001, c151. Back
352
Ibid, c153. Back
353
HC 247, Q128. Back
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