NHS England is signalling strongly that community water fluoridation is the optimum intervention to improve the oral health of children and tackle health inequality among disadvantaged communities.
The new impetus is fully supported by the Community Water Fluoridation (CWF) network, which is pressing for targeted water fluoridation in areas of high need. Dr Simon Hearnshaw, speaking for the CWF network, says that the latest unprecedented support from government inspires optimism that the first new scheme in a generation could get the go-ahead.
Health minister Jo Churchill referenced water fluoridation in the House of Commons, responding to a written question about plans for improving children's oral health. Meanwhile, Sir Paul Beresford, Conservative MP for the Mole Valley, and a dentist, gave a powerful speech in favour of community water fluoridation in Westminster.
New content1 has been added to the NHS England website and a whole page2 is dedicated to Dental Care and Fluoridation. According to NHS England, if 5-year-olds with the most tooth decay drank fluoridated water they would have 28% less tooth decay and be 45-68% less likely to need teeth removed in hospital.
Dr Hearnshaw, Chair of the Local Professional Network (LPN) in Hull which instigated the CWF Network, said: 'NHS England is making the same case that is being made by us and by Public Health England.3 The whole philosophical thrust is towards the prevention of disease and in relation to dental decay, the most effective and cost-effective measure is water fluoridation.'
He welcomed the recognition on the new NHS England web page that support for CWF schemes at a local level by NHS representatives is important. Dr Hearnshaw believes this is a reference to the co-commissioning of feasibility studies by local authorities working with the NHS to provide a strong strategic and collaborative lead.
The CWF network would like NHS England to go one step further - it would like the recurring costs of water fluoridation to be funded by the NHS because it would benefit from the associated reduction in child hospital admissions for tooth extractions, estimated to be as much as £50 million annually in the UK.
Dr Hearnshaw continued: 'We have some way to go. Last month the USA celebrated 75 years of CWF. They have around 70% coverage, compared to only around 10% in the UK. All around the world new water fluoridation schemes are being adopted. We have not seen a new scheme in the UK since 1985.'
NHS England. Menu of evidence-based interventions and approaches for addressing and reducing health inequalities. Available at: https://www.england.nhs.uk/ltphimenu/ (accessed March 2020).
NHS England. Dental care and water fluoridation. Available at: https://www.england.nhs.uk/ltphimenu/better-care-for-health-conditions-for-dental-healthcare/dental-care-and-water-fluoridation/ (accessed March 2020).
Public Health England. Research and analysis. Water fluoridation: health monitoring report for England 2018. Available at: https://www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for-england-2018 (accessed March 2020).
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Impetus from on high for community water fluoridation. Br Dent J 228, 404 (2020). https://doi.org/10.1038/s41415-020-1476-z