Mixed responses to the publication of prevention Green Paper

The British Society of Paediatric Dentistry (BSPD) and the national Community Water Fluoridation (CWF) network have reacted positively to the publication of the Green Paper 'Advancing our health: prevention in the 2020s'¹ in late July, but the British Dental Association (BDA) has described its eleventh-hour publication as a 'fire sale' and challenged the incoming government not to turn its back on evidence-based policy making.

The consultation document published by the Cabinet Office and the Department of Health and Social Care commits to rolling out more tooth brushing schemes in nurseries and schools in England. The stated aim is to consult on proposals for supervised toothbrushing to reach 30% of the most deprived 3-5-year-olds by 2022.

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BSPD spokesperson Claire Stevens said: 'This Green Paper represents a massive and welcome change in emphasis. It looks at the wider determinants of health and making it easier for people to make healthier choices for themselves and their families.

'Investing in oral health prevention instead of spending millions of pounds on the management of dental decay is the smart way forward and an approach which we hope the incoming Prime Minister will fully support. [...]

'Getting across the message "baby teeth do matter" is a priority for BSPD. We are delighted to see this Green Paper placing such emphasis on children's oral health and our Executive Committee will be discussing and responding.'

BSPD were also delighted that the Green Paper is committed to water fluoridation, a feeling echoed by the CWF network. 'Advancing our health: prevention in the 2020s' says that the NHS should work more closely with local authorities to implement water fluoridation schemes, sharing some of the ensuing savings achieved thanks to a reduced spend on the treatment of dental decay.

Simon Hearnshaw, who is spearheading the national CWF network, a powerful grouping of dental, medical and social justice organisations, said that if half the money saved on dental treatment was to be shared with local authorities, this would more than cover the recurring costs of water fluoridation.

He added: 'Although the cost of water fluoridation is not great it nevertheless represents a financial barrier to local authorities which have so many responsibilities and limited budgets. We will be doing what we can to support councils in the most deprived areas by sharing the wealth of evidence that we have amassed on the safety and efficacy of water fluoridation'.

The BDA, however, expected the Green Paper to form the 'cornerstone of the government's strategy for the NHS'. In addition to its policies on supervised tooth brushing and water fluoridation, it includes pledges to ban sales of energy drinks to under-16s, expansion of the sugar levy, and further action of childhood obesity.

BDA Chair Mick Armstrong said: 'A Green Paper setting out big ideas to finally put prevention into practice now looks more like a fire sale.

'The tragedy is this document contains numerous tried-and-tested policies, which could save children from pain and our NHS millions in treatment costs.

'In the rush to avoid the charge of "Nanny Statism" the first casualty cannot be evidence-based policymaking. Health professionals will look to the next government to show leadership, and will not let this process be swept under the carpet.'

The consultation closes at 11.59 pm on 14 October 2019.