Select Committee on Health Second Report


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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