Sir, I would like to congratulate Aubrey Sheiham on his little gem of a paper (BDJ 2006; 201: 625–626). In this paper Professor Sheiham points out that preschool children with severe untreated dental caries suffer from pain and sepsis and fail to thrive.

However – and this was new to me – after comprehensive dental treatment these children gained weight and improved their quality of life. Professor Sheiham concludes that dental treatment for these children has real benefits and that obviously prevention of dental caries would be better.

The recent Water Act 2003 opens up real possibilities of progress with water fluoridation; the Act requires Water Companies to fluoridate when, following public consultation, they are asked to do so by a Strategic Health Authority.

We would see real benefits for preschool children three years from the start of new fluoridation schemes.1

Local sections of the BDA should ask their PCTs:

  • what is the level of untreated dental decay in their 5-year-old children

  • how is the PCT's oral health plan addressing the issue

  • has the PCT considered the possibility of water fluoridation?