Sir, I was delighted to learn of the unanimous approval of Local Dental Committees (LDCs) for fluoridation of local water supplies. This is definitely a step in the right direction in the long-drawn-out debate over the safety and acceptability of artificial water fluoridation. However, securing the support of our dentally educated and engaged colleagues is, I feel, a baby step compared to our next challenge: gaining the support of the public.

Working in a tertiary care paediatric dental centre and in a high-needs primary care NHS practice, I sadly witness the devastating effects of early childhood caries on a regular basis. The fact that dental caries remains the most common chronic disease of childhood in the UK1 is appalling, and warrants a great deal more attention and resources for effective public health initiatives.

The recent Public Health England report stated that the risk of caries experience could be reduced in five-year-olds living in deprived areas by 52% by increasing water fluoride concentration from <0.1 mg/l to ≥0.7 mg/l. There were no convincing associations found between water fluoridation and hip fracture, kidney stones, Down's syndrome, bladder cancer or osteosarcoma. It concluded that water fluoridation is both safe and effective.2

Nonetheless there are still individuals who have been fuelled by misinformation and scare tactics to be staunchly anti-fluoridation. They rely on unreliable media articles and are not practised in critically appraising the poor-quality evidence behind these claims. Therefore, it is our duty to inform and advise them, and in my personal experience even adamant non-believers can be convinced to at least open their minds to the idea.

The ideal solution is mutual understanding: the LDCs should understand their population's uptake of other fluoride products (eg fluoride toothpaste, fluoride varnish) and consumption of tap water,3 and equally the public need to understand the true benefits of fluoride and its low risk of harm. An evidence-based health promotion campaign would be invaluable to disseminate this information to the masses.

In your recent Upfront article (BDJ 2019; 226; 12: 920) we encouragingly read that 'the network is at the ready to put forward dental and medical spokespeople' to answer questions and provide information; I hope this readiness is being accompanied by an active drive to urge local authorities to hold the public consultations necessary to make a change.