Water fluoridation scheme expands in the northeast

25 March 2024

Plans to expand water fluoridation in the northeast of England to help tackle tooth decay have been put out to public consultation on March 25, 2024, the government has announced.

Fluoride is a naturally occurring mineral that protects teeth against decay. Natural levels of fluoride in water can be safely topped up to provide additional protection for teeth and reduce dental health inequalities, and decades of research show it is effective and safe.

Around half of the northeast already has fluoridated water, which is helping to reduce inequalities, including parts of County Durham, Gateshead and Newcastle upon Tyne. Health officials are today launching a public consultation on proposals to widen the scheme across the whole of the region to a further 1.6m people.

Chris Whitty, chief medical officer for England, said, “Water fluoridation can reduce the prevalence of tooth decay and improve dental health equity across the UK. It should be seen as a complementary strategy, not a substitute for other effective methods of increasing fluoride use such as tooth brushing.”

Peter Kelly, regional public health director for the northeast, said, “Tooth decay is largely preventable but remains a major public health issue, particularly in more deprived areas, including parts of the northeast, and among children.

“If tooth decay takes root from a young age, it cannot be reversed so interventions like this are really important. Expanding water fluoridation to a further 1.6m people will deliver health benefits across the whole region for generations to come.”

Around six million people in England already live in areas with fluoridated water. Fluoridation is commonly used internationally as a measure to tackle tooth decay. Around 400 million people in 25 countries worldwide – including the US, Canada and Ireland – live in areas with fluoridation schemes.

The scheme is part of the government’s Dental Recovery Plan, which contains a range of measures aimed at preventing tooth decay and creating an additional 2.5m dental appointments this year.

Whilst the benefits of water fluoridation are universal, it is particularly effective for young children and vulnerable adults alongside other good habits, like brushing with fluoride toothpaste.

A 2023 oral health survey found 16 per cent of schoolchildren in year 6 living in the north east suffered tooth decay, compared to 12 per cent of children living in the south west.

Water fluoridation is shown to be effective. A 2022 health monitoring report showed five-year-olds in areas with fluoridated water in England were less likely to experience tooth decay compared to areas without, and are less likely to be admitted to hospital to have teeth removed.

Andrea Leadsom, a health minister, said, “Preventing tooth decay is a key part of our Dental Recovery Plan. We will support new parents via our family hubs programme to ensure brushing is a part of every child’s daily routine by the time they reach primary school.

“We’ll be sending mobile dental teams into schools in underserved areas to provide fluoride varnish treatments to more than 165,000 children, as well as education and advice on good oral health.

“On top of these actions, the extension of water fluoridation in places like the northeast will deliver population-wide improvements in oral health.”

Jason Wong, interim chief dental officer for England said, “Water fluoridation is a highly effective public health measure that’s already benefitted millions of people across the northeast and other parts of the country over several decades.

“Reducing tooth decay supports wider health and wellbeing and reduces health inequalities by narrowing differences in dental health between more and less deprived areas, and this important measure forms a key part of our dental recovery plan which aims to improve access to NHS dental services across England.”

Greg Fell, president of the Association of Directors of Public Health said, “Tooth decay is the leading cause of hospital admissions for five-to-nine-year-olds. That has a serious impact on both individuals and their families, with days missed from education and work, as well as a significant cost to the NHS.

“While families need to be equipped with the knowledge and skills to oversee good dental hygiene, there is much we can do as a society to improve the situation and water fluoridation schemes are the single most effective public health measure for reducing tooth decay rates. This proposed expansion therefore presents a real opportunity to improve health and wellbeing in the north east, and reduce the unacceptable gap in health outcomes that people living in different areas of the country currently experience.”

In the Health & Care Act 2022, Parliament granted powers to the secretary of state to introduce new water fluoridation schemes. The scheme is supported by local authorities in the region and the water company has experience of operating fluoridation schemes.

The government’s consultation into the plans will last 12 weeks, after which it will gather responses and publish its decision on whether to widen the scheme.

Claire Stevens, BSPD Spokesperson, said, “BSPD supports the fluoridation of public water supplies in communities where the burden of dental decay is severe enough to warrant this public health measure and fluoridation is technically feasible. This announcement is monumental. It will be the first one conducted in an area of the UK for several decades. So, we welcome and will support this consultation - and look forward to seeing the outcomes.  Dentistry is in crisis at the moment and now children’s oral health is everyone’s business - where creative approaches using proven interventions that deliver return on investment are more important than ever.”