APPENDIX 21
Memorandum by the National Alliance for
Equity in Dental Health (PH 40)
The National Alliance for Equity in Dental Health
is a consortium of more than 40 medical, scientific and voluntary
organisations campaigning to extend water fluoridation to improve
the dental health of the UK's most vulnerable children (see attached
list of supporting organisations).
One of this government's prime objectives is
to reduce health inequalities.
The Government commissioned an independent systematic
review of the safety and benefits of water fluoridation. The review
is being conducted at the University of York's NHS Centre for
Reviews and Dissemination. Preliminary results confirm that fluoridation
reduces dental health inequalities both between fluoridated and
non-fluoridated districts and, importantly, significantly narrows
the dental health "gap" between young children living
in poverty and their more affluent peers.
Furthermore preliminary draft results confirm
the current scientific position—in particular that fluoridation
is safe. There is no evidence that water fluoridation is linked
to cancer, bone disease, or any other adverse effect.
In 1976 Barbara Castle as Secretary of State
for Social Services in the Labour government published a consultative
document[63]
stressing for the first time in the reorganised health service
that "the preventive approach should permeate and inform
all aspects of the health services".
— The document said that dental health
provides "a dramatic illustration of regional and socio-economic
differences". That statement remains true today.
— The document said that "very
few preventive measures are as effective or are so easy to implement
as the fluoridation of water supplies . . . (it) has been established
beyond doubt as being completely safe and the most effective method
of reducing the incidence of dental caries in the community. .
. . Yet of all recent initiatives in preventive medicine this
has been in Britain, though not in other countries (eg the United
States, Canada, the Republic of Ireland) the most disappointing".
That statement remains true today.
— The document highlighted fluoridation
as a highly cost effective public health intervention. That remains
true today.
— The 1980 Black Report[64]
highlighted the evidence that "working-class people make
less use of dental services". The 1987 and 1992 versions
of The Health Divide[65]
highlighted the fact that though dental health had shown a marked
improvement over the previous 20 years, more adults in lower social
groups had no natural teeth than in more affluent groups, and
five year olds in manual classes had on average twice as many
decayed teeth compared with those from non-manual classes. Again,
this remains true today.
— More recently, Sir Donald Acheson's
Independent Inquiry into Inequalities in Health[66]
recommends the fluoridation of the water supply based on its proven
efficacy in reducing persisting inequalities in dental health.
SUMMARY AND
RECOMMENDATION
Inequalities in dental health in the UK remain
wide. Water fluoridation produces a guaranteed, measurable reduction
in these inequalities in the youngest and most vulnerable children.
This Alliance recommends the early introduction of legislation
to ensure that health authorities are no longer prevented from
implementing water fluoridation schemes where there is both need
and local public support.
July 2000
63 Health Departments of Great Britain and Northern
Ireland (1976): Prevention and health: everybody's business.
A reassessment of public and personal health. HMSO London. Back
64
Black D A K: Inequalities in Health: report of the working group
in inequalities in health. 1980. DHSS, London. Back
65
Whitehead M: The Health Divide: Inequalities in health in the
1980s. 1987. Health Education Council, Wembley. Back
66
Acheson D: Independent Inquiry into Inequalities in Health Report.
1998. HMSO, London. Back
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