Adding fluoride to the water supply has “only a small benefit” for children’s teeth

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Scientists have found that adding fluoride to the water supply has only modest benefits for children’s dental health.

The Government has drawn up plans to introduce fluoridation of drinking water in England to reduce tooth decay, subject to public consultation.

However, researchers have found that the benefits of fluoride in water have declined from studies half a century ago, when fluoridated toothpaste was less widely available in the UK.

Funded by the National Institute for Health and Care Research and led by the University of Manchester and the Salford Royal NHS Foundation Trust, the Catfish study followed nearly 3,000 children in Cumbria over a six-year period.

The children were split into two cohorts at two sites – one in West Cumbria, where water fluoridation was reintroduced in 2013, and the other in the rest of Cumbria, where water does not contain fluoride.

In West Cumbria the younger cohort were born after water fluoridation was introduced meaning they had the full impact of the measure.

The older cohort was around five years old when fluoride was reintroduced into the water supply, meaning they benefited mostly for the teeth already in the mouth.

The results showed that in the younger cohort, 17.4 percent of children in fluoridated areas had decayed, filled or missing baby teeth, compared to 21.4 percent for children of the same age group in non-fluoridated areas.

Meanwhile, in the older cohort, 19.1 percent of children in fluoridated areas had decayed, filled or missing permanent teeth, compared to 21.9 percent of children in non-fluoridated areas.

Water fluoridation “should be carefully considered”

Despite their findings, published in the journal Public Health Research, the scientists said fluoridation should be considered alongside other measures to protect children’s dental health — particularly children from disadvantaged groups who are more likely to be affected by tooth decay are.

dr Michaela Goodwin, from the University of Manchester and lead researcher on the project, said: “Although water fluoridation is likely to be inexpensive and has shown improvement in oral health, it should be carefully considered along with other options, particularly as the disease is concentrated in certain groups .

“Caries is a non-trivial disease, which is why measures to combat it are so important.

“Pulling children’s teeth under general anesthesia is risky for the child and is the most common reason for general anesthesia in children between the ages of five and nine.

“Caries on teeth are painful and can impact sleep patterns, learning, attention and many aspects of overall health.”

The Health and Care Act, which received royal assent in April, gave the health secretary new powers to mandate fluoridation across the country, following a public consultation. Previously, responsibility for fluoridation lay with local authorities.

Resistance to the addition of fluoride

Initiatives to add fluoride to local water supplies have met with resistance.

Southampton City Council voted against fluoridation in 2011 after hundreds of people signed a petition claiming it was “unethical because it constitutes mass medication without consent”.

Professor Chris Whitty, the Chief Medical Officer for England, and his counterparts across the UK have said that the arguments against fluoridation are “exaggerated and unproven”.

Research from the Office for Health Improvement and Disparities and the UK Health Security Agency, released earlier this year, found children and young people in areas of England with higher fluoride levels were up to 63 per cent less likely to be hospitalized for dental withdrawals due to rot than in areas with low fluoride concentrations. The difference was greatest in the most deprived areas, where children and young people benefited the most from fluoridation.

The government agencies’ report also found that up to 56 percent of hospital admissions to remove decayed teeth among children and adolescents in the most disadvantaged areas could be prevented by water fluoridation programs.

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