UK - Daily Echo - In my View

By STEPHEN PECKHAM,
Reader in health policy at the London School of Hygiene and tropical Medicine

Time to ditch fluoridation for a better option
FOR the past three years there has been much debate about the need to tackle poor dental health within the city. Unfortunately, the only solution put forward has been water fluoridation. This is despite a poor evidence base, overwhelming public opposition, rising costs and growing concern about increased rates of fluorosis among children living in areas with fluoridated water.
A recent Radio 4 programme featured an item on effective ways of tackling dental problems in children in order to reduce dental health inequalities. Not once did the dental health professionals mention water fluoridation. The discussion focused on the success of the Childsmile scheme which targets prevention services to those children most in need. This scheme, which started in Glasgow, has now been rolled out across Scotland and promotes the use of fluoride varnishes for pre-school children combined with community -based education programmes.
I have spent time talking to dental health professionals and find the majority rarely mention water fluoridation, preferring instead to concentrate on targeted prevention and treatment programmes.
Proven alternative
There is good quality evidence to support fluoride varnishing and education programmes for children when delivered collaboratively by local health and community agencies. The Childsmile scheme has been proven to work well and provides a template for best practice which is being copied in other areas of the UK. it also makes sense to engage more health and social care workers in oral health promotion. Simple screening techniques should be taught to all health professionals who work with pre-school children and proper referral processes to dental services put in place. Why not do this in Southampton?
With the South Central Strategic Health Authority now part of a new larger body called NHS South of England, there is the opportunity to revisit the decision to fluoridate our local water supply. Now that Southampton City Council opposes water fluoridation, the last vestige of local support for the scheme has disappeared. With the demise of SCSHA, there can be no justification for NHS South of England to impose an unwanted, ineffective and expensive scheme on local people, especially when both the city and county councils have vowed to stop fluoridation when they have the powers to do so in 2013. To proceed now would not only be an act of unprecedented arrogance, it would also be a huge waste of NHS resources.