Sir, I was interested to read the recent letter (BDJ 2009; 206: 187) by my former Merseyside colleague John Doughty. I agree with him that the arguments in favour of water fluoridation have weakened since 1974–75 when he was Area Dental Officer for Sefton AHA. Indeed, as early as 1987–88 my colleagues and I in the North West published two papers in the BDJ making just that point.1,2 The BDA has argued for years in favour of a targeted approach to water fluoridation to around 30% of the UK population.

Colleagues from Southampton have highlighted the particular problems in deciduous teeth because:

  • DMFT values have been resistant to change (see South Central Strategic Health Authority's consultation paper at http://www.southcentral.nhs.uk/ document_store/1220390484zWbv_water_fluoridation_consultation.pdf

  • Severe deciduous caries impacts on the quality of life of young children3

  • The resulting need for dental general anaesthetics in Southampton (more than 500 cases per year):

    • are expensive for the NHS

    • have short term psychological effects on the young children involved4

    • have long term effects in causing dental anxiety among adults.

Professor John Newton, Regional Director of Public Health, South Central Strategic Health Authority has once again emphasised the safety of water fluoridation and I congratulate the SHA on their recent decision in favour of new water fluoridation schemes for Southampton (http://www.southcentral.nhs.uk/news.php?news_id=177).

I shared John Doughty's frustration at our failure to implement water fluoridation in the 1970s, but urge him to renew his efforts in the North West of England. It is just possible that this time someone might listen to him.