Dental inequalities – water fluoridation should be ‘carefully considered’ with other options

Water fluoridation 'not enough' to solve dental health inequalities

Introducing water fluoridation is not enough to improve dental health inequalities across the UK.

This is according to a new study released by the University of Manchester.

The seven-year-study concluded that fluoridation of the water supply may only provide a modest benefit to the dental health of children.

It added that it is likely that water fluoridation is a cost effective way to help reduce the £1.7 billion spent on dental caries by the NHS.

The study assessed the dental health of two groups of young children over a six year period in West Cumbria, where water fluoridation was reintroduced in 2013, and the rest of Cumbria, which remains free of fluoride.

Decayed, filled or missing

In West Cumbria, the younger cohort were born after water fluoridation was introduced. This meant they had the full effect of water fluoridation.

The older cohort was aged around five when fluoride was reintroduced into the water supply. This meant they mainly received the benefit for those teeth that were already in the mouth.

Results showed:

  • In the younger cohort, 17.4% of the children in fluoridated areas had decayed, filled or missing milk teeth. The number was 21.4% for children in non-fluoridated areas
  • In the older cohort, 19.1% of the children in fluoridated areas had decayed, filled or missing permanent teeth. The number was 21.9% for children in non-fluoridated areas.

Other collaborators on the study included King’s College London, Cambridge University, Salford Royal Foundation Trust and the specialist dental services at North Cumbria Integrated Care NHS Foundation Trust.

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Carefully considered

Professor Mike Kelly is a senior member of the research team from The University of Cambridge. He said: ‘Health inequalities are a feature of all societies, including the UK.

‘The poor dental health of children from the most disadvantaged communities and the excess number of children having general anaesthetics each year still needs to be addressed. We need to continually look at measures which can help prevent the unnecessary burden of pain and suffering.’

Dr Michaela Goodwin, from the University of Manchester and the study’s senior investigator, said: ‘While water fluoridation is likely to be cost effective and has demonstrated an improvement in oral health. It should be carefully considered along with other options, particularly as the disease becomes concentrated in particular groups.

‘Tooth decay is a non-trivial disease which is why measures to tackle it are so important. The extraction of children’s teeth under general anaesthetic is risky to the child. It is the most common reason for children between the ages of five and nine to have a general anaesthetic.’

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