November 20, 2007, Isle of Man
Professor Michael Lennon, OBE
Chair, British Fluoridation Society
Power Point Presentation
Slide 1.
Water Fluoridation
Professor Michael Lennon OBE
University of Sheffield
and
Chair, British Fluoridation Society
Slide 2.
Fluoride occurs naturally in all water supplies.
At the optimum level, it reduce tooth decay.
- The optimum level for dental health is one part of fluoride per million parts of water.
- In Britain, around 500,000 people drink water whose natural fluoride content is high enough to benefit their dental health.
- Worldwide, over 50 million people drink water naturally fluoridated at the optimum level for dental health.
Slide 3.
Since the mid-1940s, it has been possible to
replicate the benefits of natural fluoridation.
- Around 350 million people in over 30 countries drink water whose natural fluoride content has been supplemented to the optimum level by means of water fluoridation schemes.
- In the UK, 5.5. Million people drink fluoridated water - in the North east, West Midlands, East midlands, Cheshire, Cumbria, Lincolnshire and Bedfordshire.
Slide 4.
In the United States, where individual liberty
is prized, over 170 million people drink fluoridated water.
- Forty six out of the 50 largest US cities receive fluoridated water supplies, including New York, Washington DC, Chicago, Los Angeles and San Francisco.
- In his report the US Surgeon General said:
“Fluoridation continues to be the most cost effective, practical and safe means for reducing and controlling the occurrence of tooth decay in the community.”
Slide 5.
Technical aspects
The Water Act 2003 (Section 58)
- hexafluorosilicic acid (H2SiF6)
- sodium hexafluorosilicate (Na2SiF6)
Drinking Water Inspectorate (2005): Code of Practice on Technical Aspects of Fluoridation of Water Supplies. 2005. London. HMSO
- Compounds must meet stringent European Standards that specify the physical properties and purity criteria required
- The Drinking Water Inspectorate enforces the Standards
Slide 6.
Some parts of the British Isles still have unacceptably
high levels of tooth decay among children.
- Children in the non-fluoridated Isle of Man and the North West of England have almost twice as many decayed, missing and filled teeth as children in fluoridated Birmingham and the West Midlands.
- General anaesthesia for children’s dental treatment is used five times more often in non-fluoridated Greater Manchester, and NINE TIMES MORE in the Isle of Man than in fluoridated Birmingham and The Black Country.
Slide 7.
Decayed teeth – how non-fluoridated Manchester and the Isle of Man
compare with fluoridated Birmingham East and the North PCT
Average number of teeth decayed, missed and filled per 100 five year olds (2005/06 study).
North West
(non-fluoridated)
200 teeth affected per 100 children
Isle of Man
(non-fluoridated)
189 teeth affected per 100 children
West Midlands
(70% fluoridated)
102 teeth affected per 100 children
Slide 8.
Tooth extractions – how non-fluoridated Manchester and the Isle of Man
compare with fluoridated Birmingham East and The Black Country
- General anaesthetics given to children under 10 years for tooth extraction (2002/3). (Isle of Man data 2006/07)
(Graphics showing:
Greater Manchester 136 per 100,000 population
Isle of Man 267 per 100,000 population
Birmingham and the Black Country 30 per 100,000 population)
Slide 9.
In all social groups, children in fluoridated areas have significantly less tooth decay
than similar children in non-fluoridated areas.
- However, in social classes III, IV and V, the benefits of fluoridation are particularly obvious.
(Graphics showing: mean number of decayed missing or filled teeth per 5-year-old child
versus high/low fluoride areas for each social class I&II, III, and IV&V
Social class I&II High fluoride 1 versus 1.7 low fluoride.
Social class III High fluoride 1.8 versus 3.0 low fluoride.
Social class IV & V High fluoride 1.7 versus 3.7 low fluoride.)
Data from York Review, 2000 – quality of evidence level B or C
Slide 10.
The efficacy and safety of water fluoridation have been endorsed by many health organisations.
- In 1994, a World Health Organization Expert Committee on Oral Health concluded that:
“fluoridation for the purpose of preventing tooth decay is safe and effective.”
- The safety of fluoridation has been endorsed by the Royal College of Physicians, the British Medical Association and many other leading medical and scientific organisations.
Slide 11.
Outcomes of reviews of the evidence on safety by leading medical and scientific bodies.
- ROYAL COLLEGE OF PHYSICIANS: 1976
“There is no evidence that the consumption of water containing approximately 1mg/litre of fluoride is
associated with any harmful effects.”
- NHS CENTRE FOR REVIEWS AND DISSEMINATION at the UNIVERSITY OF YORK: 2000
“...no association was detected between water fluoridation and mortality from any cancer, or from bone or thyroid cancers specifically.”
- MEDICAL RESEARCH COUNCIL WORKING GROUP CHAIRMAN: 2000
“There is no reason to believe that water fluoridation is responsible for any adverse health effects.”
Slide 12.
The strong ethical basis for fluoridation: preventing disease, pain, suffering and anxiety.
- THE LORD BISHOP OF NEWCASTLE:
“I cannot think of another measure that could be introduced so economically
and yet produce such a healthy gain for so many.”
- PROFESSOR JOHN HARRIS, Professor of Bioethics at the University of Manchester,
“....since dental decay may itself be responsible for a small number of deaths each year from anaesthesia used in dental treatment, it could be unethical not to fluoridate water where it is practicable to do so.”
Slide 13.
Results of NOP public opinion survey, 2005. Sample size 2000+
Percentage of people who think fluoride should be added to water if it can reduce tooth decay.
67% YES
22% No
11% Don’t know
Slide 14.
Fluoridation schemes are subject to extensive public consultation, discussion and debate.
In the UK health authorities wishing to fluoridate water supplies to reduce tooth decay must undertake public consultation in the areas potentially affected.
Consultations conducted in the 1980s and 90s have included:
- Media publicity to ensure maximum awareness
- Mass distribution of consultation materials, including household leaflet drops
- Opinion surveys conducted by independent research companies
- Public meetings
- Radio and television debate and phone ins
- Formal consultation with local authorities
- Engagement with community organisations
Slide 15.
For more information contact:
The British Fluoridation Society
Ward 4
Booth Hall Children’s Hospital
Charlestown Road
MANCHESTER M9 7AA
Tel/Fax: 0161 918 5223
Email: bfs@bfsweb.org
Website: www.bfsweb.org
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