South West Water likely to be told to introduce fluoride to Cornwall's water

South West Water (SWW) is likely to introduce fluoride to Cornwall's water supply. In England and Wales, less than ten per cent of the population have fluoride added to their water, but Cornwall Council believes it is now necessary to help tackle the worsening levels of tooth decay among Cornwall's children and the increasing lack of NHS dentists.

At its meeting today (Wednesday, November 6), the council's health and adult social care overview and scrutiny committee is likely to support a motion passed by full council in April to start the fluoridation of the water supply. The committee is due to support the leader of the council, Linda Taylor, writing to Wes Streeting, the Secretary of State for Health, to start a consultation process with a view to instruct SWW to initiate fluoridation of the water supply in Cornwall.

The process is mostly found in water supplies in the West Midlands, North East and North West of England. The amount of fluoride that naturally occurs in water varies from region to region. In the region covered by South West Water, water has a low naturally occurring level of fluoride that is below 0.1 milligrams per litre.

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A report to the committee written by the council's director of public health and consultant in public health states: "Children in Cornwall are experiencing worsening oral decay levels and worsening access to NHS dental services. The burden of dental disease is experienced disproportionately by those from disadvantaged backgrounds and stark oral health inequalities exist.

"The oral health situation in children in Cornwall shows a concerning deterioration as they get older. The 2023 Oral Health Survey of Children in Year 6 has shown that the percentage of children examined with experience of dental decay in Cornwall was 26.2 per cent, double that of the region (12.1 per cent). In the children examined 4.9 per cent reported pain in their teeth often or very often which is concerning."

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The report says that water fluoridation is an effective oral health prevention measure. There is evidence of considerable additive benefits from community water fluoridation on top of the use of fluoride toothpaste. Furthermore, the benefits of community water fluoridation are greatest in the most deprived areas.

"While there are concerns about water fluoridation, there is no strong evidence of adverse effects to health or the environment in fluoridating the water supply in line with regulatory levels. The fluoridation of the public water supply is supported by the four Chief Medical Officers of the UK stating, 'on balance, there is strong scientific evidence that water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving dental health equality across the UK'."

The committee will hear that water fluoridation is the most cost-effective oral health improvement intervention and for every £1 invested into water fluoridation schemes, there are savings of £12.71 after five years, and £21.98 after ten years.

Community water fluoridation was first introduced in the UK over 50 years ago. Over 6.1 million people in the UK (10 per cent) receive fluoridated water. Similar schemes operate around the world covering an estimated 400 million people, including in the USA, Canada and Ireland.

Under the Health and Social Care Act 2022 the powers to instruct a water company to initiate fluoridation have reverted from local government to the Secretary of State for Health and Social Care.