From Ann Wills
From Maria Caulfield MP
Parliamentary Under Secretary of State for Primary Care and Patient Safety
39 Victoria Street
London
SW1H 0EU
Your Ref: KM21344
PO-1360008
The Rt Hon Kit Malthouse MP
By email to: kit.malthouse.mp@parliament.uk
22 November 2021
Dear Kit,
Thank you for your correspondence of 8 September on behalf of your constituent, Ms Jennifer Johnson, about the fluoridation of water. Please accept my sincere apologies for the delay in replying.
I understand Ms Johnson’s concerns and I would like to thank her for raising this important issue with you.
The Health and Care Bill will allow the Secretary of State to introduce, vary or terminate water fluoridation schemes. However, I can assure Ms Johnson that any proposed new water fluoridation scheme will be subject to public consultation.
Fluoride is found naturally in water supplies and in some foods. There are areas of the country where levels of fluoride in drinking water are naturally at similar levels to those seen in artificial fluoridation schemes. We have known since the 1930s that access to
fluoride in drinking water is associated with a reduced level of tooth decay. It is estimated that, around 400 million people in some 25 countries are currently served by water fluoridation schemes. This includes around six million people in England, mainly in the West Midlands and the north east.
There have been a large number of individual studies of the effects of water fluoridation, using a wide variety of research methods. Where possible, it is preferred to look at reviews of scientific evidence published in peer-reviewed scientific literature. These reviews often set tight criteria for what will be acceptable research in terms of quality.
There is no credible scientific evidence that fluoride in drinking water at UK levels causes adverse health effects. Conversely there are a great many high-quality, peer-reviewed studies that have found that it does not have such effects. Recent reviews of the extensive scientific literature, by several authoritative bodies across the world have concluded that levels of tooth decay are lower in fluoridated areas.
Previously, there have been suggestions that fluoridated drinking water may cause certain adverse effects, such as a rare form of bone cancer (osteosarcoma), Down’s syndrome or effects on the kidney. However, the evidence does not support this, and various authoritative expert evaluations from different international organisations all agree that drinking-water fluoridation schemes are unlikely to cause adverse health effects. The more
recent reviews include evaluation of possible neurological effects and report that there is no convincing evidence of harms to general health.
The UK Chief Medical Officers recently published a statement on water fluoridation being an effective public health intervention for improving the oral health of both adults and children. The statement can be viewed at www.gov.uk/government/publications/water fluoridation-statement-from-the-uk-chief-medical-officers.
Poor oral health affects people of all ages. It can cause pain and suffering and affect an individual’s ability to function in and enjoy day-to-day life. It can reduce children’s ability to learn, thrive and develop and, in older and more vulnerable populations, poor oral health may ultimately impede their ability to nourish themselves and communicate. Water fluoridation is the only intervention to improve dental health that does not require sustained behaviour change over many years. It is therefore particularly beneficial for individuals and communities at increased risk of tooth decay, such as those from more deprived backgrounds and vulnerable groups, including those with a disability that prevents them from effectively caring for their teeth.
I can assure Ms Johnson that the level of fluoride in drinking water is closely monitored. The World Health Organization has recommended a maximum level of 1.5 milligrams of fluoride per litre of water (mg/l). This value is intended to maximise the oral health benefits and be protective of public health over a lifetime of consumption, taking into account the possibility of dental mottling, which might be unsightly. The maximum level of 1.5 mg/l is also the regulatory upper limit for fluoride set out in the Water Supply (Water Quality) regulations for England (monitored by the Drinking Water Inspectorate) and applies both to fluoridation schemes and fluoride naturally present in water. Public Health England (PHE), an executive agency of the Department of Health and Social Care, undertook water fluoridation responsibilities on behalf of the Secretary of State until its dissolution on 30 September 2021. PHE’s last report, published on 22 March 2018, is available at www.gov.uk/government/publications/water-fluoridation-health-monitoring-report-for england-2018.
The next report containing an analysis of the effects of water fluoridation schemes on the health of the people living in the areas covered by water fluoridation arrangements is due to be published in 2022.
I hope this reply is helpful.
Yours sincerely,
MARIA CAULFIELD MP
posted by Bill at
2:27 PM
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