LDC conference votes unanimously to applaud local authorities taking forward water fluoridation


The national conference of Local Dental Committees which represents more than 25 thousand NHS dentists working in high street practices is supporting community water fluoridation in areas of need. A motion applauding those local authorities taking forward water fluoridation was  approved unanimously at last week’s conference (7.6.19).

The vote is an important milestone for the newly formed Community Water Fluoridation network. The network’s role is to make sure that public consultations are informed by scientific evidence and accurate representation of the needs of families in their locality.

Local Dental Committee members have provided the impetus for the network which is supported by a wide range of dental, medical, child and health-related organisations. Among them are NHS England, the British Fluoridation Society, the National Children’s Bureau, the British Dental Association, the British Society of Paediatric Dentistry and the Association of Dental Groups.

Simon Hearnshaw, a dentist who works for Health Education England, and who put forward the motion, said: “To have this kind of unanimous response from dentists highlights just how strongly we all support fluoridation of water and want to see the oral health of our young patients improve.”

Water fluoridation is approved by parliament but since 2012, local authorities which want to implement the public health measure must first carry out a public consultation.

The network is at the ready to put forward dental and medical spokespeople from local communities who will answer questions and describe the dental challenges they are dealing with almost daily and the difference water fluoridation could make. They will be ready to attend events and meetings over the course of the consultations so that there is consistent dental representation.

In 2016-17, more than 42,000 hospital admissions in England were for the extraction of decayed teeth, mostly in very young children, who cannot be treated in general practice, costing more than £50m. Areas where water is not fluoridated have a disproportionately higher number of children suffering from dental decay.

Six million people in the UK live in areas where the water supply is fluoridated and a further one third of a million live in areas where the water has naturally occurring fluoride. Water fluoridation is supported by:

  • The World Health Organisation

  • The British Medical Association

  • The British Dental Association

  • The Royal College of Paediatrics and Child Health

  • Federation Dentaire Internationale

  • International Association of Dental Research

  • Faculty of Dental Surgery of the Royal College of Surgeons

  • Faculty of General Dental Practice (UK)

  • The Oral Health Foundation

  • The World Health Assembly  

Public Health England says fluoridation “is an effective and safe public health measure to reduce the prevalence and severity of dental caries, and reduce dental health inequalities.” (1)

(1) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/692756/EXECUTIVE_SUMMARY_Water_Fluoridation_Health_monitoring_report_for_England_2018_DR.pdf

Notes to Editors

The motion put to the LDC conference was: This Conference applauds Councils moving forward with CWF proposals and commits to support them as they move through the regulatory process.

 For more information, contact Caroline Holland 020 8679 9595/07974 731396




Support for fluoridation in Green Paper welcomed by the National CWF network


The National Community Water Fluoridation (CWF) Network welcomes the commitment in the Green Paper ‘Advancing our health: prevention in the 2020s’ that the NHS should work more closely with local authorities to implement water fluoridation schemes. The Green Paper has been published by the Cabinet Office and by the Department of Health and Social Care.

Water fluoridation is a public health measure which adjusts the amount of naturally occurring fluoride to the optimum level – one part per million - to prevent dental decay.  Strong evidence shows that it reduces dental decay. NHS England is offering to share with local authorities 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, praised the initiative, saying 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.”

Alan Johnson, the former MP and Secretary of State for Health and a long-time proponent of water fluoridation commented: “In an NHS that is truly focused on prevention and tackling the obscene health inequality statistics, Community Water Fluoridation has to be part of the strategy.”

“We should not accept a situation where children are being hospitalised in droves to have their teeth removed whilst the greatest single proven solution (CWF) is not used widely enough.”

“Ensuring that local authorities don’t face an additional fiscal pressure as a result of fluoridation is a practical way for the NHS to be true to its founding principles by supporting local authorities like Hull and many others in the North who are determined to act on behalf of children in areas where tooth decay is most prevalent.”

Simon Hearnshaw said the network would be responding in detail to the consultation and in particular making suggestions around the role of  water companies which have the job of implementing water fluoridation.

  • British Dental Association

  • British Fluoridation Society    

  • The Local Dental Network Fluoridation Group        

  • British Society of Paediatric Dentistry

  • Faculty of General Dental Practice

  • British Association of Dental Therapists

  • British Oral Health foundation 

  • British Society of Dental Hygiene and Therapy

  • National Children's Bureau

  • Association of Dental Groups


  • British Association fro the Study of Community Dentistry

  • The Society of British Dental Nurses

  • The Dental Professionals Alliance 

  • The National Oral Health Promotion Group

  • Teeth Team

For more information or to interview one of the network, please contact Caroline Holland: 0208 679 9595/07974731396


Evidence on Fluorides


Evidence on Fluorides

Water Fluoridation

After 50 years’ experience of water fluoridation in the UK and nearly 70 years’ experience in the United States, there have been no credible scientific studies to indicate that water fluoridation has caused harm to health.

There have been a number of authoritative reviews of water fluoridation undertaken since the first schemes in 1945.  These contain scientific opinion on both the effectiveness and safety of water fluoridation, reviews undertaken in the past five years are:

You can find the following commentaries that have been published in response to the Cochrane systematic review on water fluoridation in the links below.

The common finding of the reviews looking at dental health is that levels of tooth decay are lower in fluoridated areas and, for reviews which looked at general health effects, that there is no credible scientific evidence that water fluoridation is harmful to health.

The Public Health England report, ‘Water Fluoridation Health Monitoring for England (2014)’ compared a range of dental and non-dental health indicators in fluoridated and non-fluoridated areas in England and can be viewed at: https://www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for-england-2014 


Oral Health Interventions 2016 - Return on Investment


Targeted supervised tooth brushing programme aimed at 5 year olds – 


After 5 years for every £1 spent £3.06 back
After 10 years for every £1 spent £3.66 back

Targeted fluoride varnish programme aimed at 5 year olds – 

After 5 years for every £1 spent £2.29 back
After 10 years for every £1 spent £2.74 back

The combined supervised tooth brushing and fluoride varnish for every £1 spent after 5 years £5.35, after 10 years £6.40 

Then add water fluoridation - The PHE table states for water fluoridation - 

After 5 years for £1 spent £12.71back
After 10 years for £1 spent £21.98 back

In total by using all three interventions in combination for every £1 spent after 5 years = £18.06, after 10 years £28.38.


Annual Teeth Team Report 2016


In 2012 Public Health England commissioned a survey, Department of Health (2012) into the dental health of five year- old children. This survey indicated 27.9% of 5-year-olds in England have tooth decay.

The survey also revealed:

  • Children with decay have on average between 3 and 4 teeth affected by decay, treated or untreated.

  • 24.5% of children have untreated decay.

  • 1.7% of children have sepsis (infection) in their mouths.

Unfortunately, this national survey also confirmed that 43.4% of five-year-olds in Hull had tooth decay, compared with the national average of 27.9%. The same survey also revealed 39.2% in Hull and 20.1% for the East Riding suffered from untreated decay.

Figures for the Yorkshire and Humber region showed 29.3% of children were not undergoing treatment to tackle the decay, which may suggest there is an issue of dental neglect.

A further survey was published in May 2016 by Public Health England, Department of Health (2015) again focusing on the dental health of five year- old children. This latest report concluded that 24.8% of five-year-old children in England whose parents gave consent for participation in this survey had experience of dental decay. Among these children with some experience of obvious decay, the average number of teeth that were decayed, missing or filled was 3.4

For the Yorkshire and Humber region, the survey also revealed:

  • 2.2% of children had sepsis compared with 1.4% of children nationally

  • 11% of children had experienced fillings compared with 12% of children nationally

  • 3.7% of children had one or more teeth extracted compared with 2.5% of children nationally.

These statistics highlight the fact that there clearly is a regional problem which most certainly needs to be addressed. If we want to break the cycle of poor oral health amongst generations of families in the Yorkshire and Humber region it is paramount there is a “joined-up” approach where a range of services work collaboratively in partnership, rather than in isolation, which is often the case.

If we compare this to the map of the indices of deprivation, we can see direct correlation between the prevalence of disease and areas of deprivation – See Page 3 of the Teeth Team report 2016.

Undoubtedly, encouraging parents to access routine primary dental care for their children should be high on the agenda, as should raising the awareness of the importance of regular tooth brushing with a fluoride toothpaste and the provision of dietary advice, including information on hidden sugars and the frequency of their consumption.

On a positive note, if we look at the specific figures pertaining to Hull, the same survey identified that 37.8% of five-year-old children had experience of dental decay. This is an  improvement on the 2013 survey where 43.4% of five year- olds had experienced decay, showing a reduction of 5.6%.  However  Looking at the 95% confidence intervals from a statistical point of view, the improvement is not significant.

....but even this improvement still leaves Hull at the bottom of the dental health league with a handful of other Cities, so we need to do more for our children and our population generally.


Hull Oral Health Statistics: Latest Survey for 5 Year Olds 2015


In Hull by the time the average child gets to 5 years old he or she will have on average 1.6 decayed, extracted or filled teeth.

Those children with decay (normally from the poorest communities in the City) will have on average 4.1 decayed, extracted or filled teeth and those with the poorest dental health will have 4.6 teeth decayed, extracted or filled.

On Average by the time a child in hull reached 5 years of age, 12.7% will have decay in their front teeth and in poorer areas this will rise to 16.77%

Both the proportion of children experiencing tooth decay and the severity of tooth decay increases with increasing deprivation. Hull has high levels of deprivation as compared with other local authorities and is within the 5% most deprived local authorities in England.  Just over 30% of children under 16 years old live in poverty which is the highest in North Yorkshire and Humber.

There have been no measurable improvements in proportion of 5 year children with tooth decay or the severity of tooth decay levels in children in Hull between 2007/08 and 2014/15. So in spite of all the efforts by the dental community between 2007 and 20015 there has been no significant improvement in the dental health of 5 yr olds. We need help.

This data demonstrates that Hull is in the top 10 % worst areas in England out of 152 Local Authority Areas BUT it also demonstrates the INEQUALITY in dental health in our City.  

The results of the 5yr Old survey are available at:


Overview of Oral Health: Public Health England North East


In the North East, areas with fluoridation have less decay in 5 year old children and rates of decay are around double in non-fluoridated areas.

Data demonstrates that there is a huge difference in acute infection and pain between children growing up in fluoridated Gateshead and Newcastle, compared with non-fluoridated Middlesbrough and Sunderland. This is 2 - 3 times the difference.

Sadly, infected teeth and severely decayed teeth causing pain need to be extracted. Here are the rates of extraction across the North East:


Unsurprisingly, there is a trend of more extractions in Sunderland, Darlington and Middlesbrough compared to Gateshead and North Tyneside. Again, these can be over 3 times the difference.

According to evidence, we can expect 59% fewer hospital admissions in fluoridated areas and this certainly seems to be the case in Teesside. Hartlepool has half the rates of general anaesthetics compared with non-fluoridated Redcar & Cleveland and Middlesbrough.

In addition, In Darlington, Middlesbrough and Sunderland; decayed front teeth is the reality for 1 in 10 children and the local data shows fluoridation can half these rates.

Evidence tells us that fluoridation benefits everyone, especially less privileged children. Therefore, it is great at reducing inequalities and we can expect to see tooth decay reductions of 53% in the most deprived communities, compared to 23% in affluent communities. The gap in decay rates between rich and poor in Hartlepool is much smaller than the rest of non-fluoridated Teesside.

Although we have talked about all the benefits of fluoridation, it is important to consider the potential side effects - one of these being mild fluorosis. It affects a small number of children but rates are higher in fluoridated Newcastle compared to non-fluoridated Manchester.