1. Using the legislation in the Health & Social Care Act 2012 and PHE toolkit to improve oral health
Dr John F Beal MBE
Hon Senior Lecturer in Dental Public Health,
University of Leeds
and former Regional Consultant in Dental Public Health,
Yorkshire and the Humber

2. Oral Health in children
While improved
Inequalities
Many places over 1/3 5-year-olds have tooth decay
Especially North West, Yorkshire & the Humber and London

3. Consider water fluoridation
Effective
Cost-effective
Reduces need for dental treatment
Reduces general anaesthetics for tooth extraction
Reduces inequalities
All ages benefit – children, young adults and older people

4. Fluoride varnish programmes
They are effective
BUT
Don’t start until children at school
Only in those schools in programme
Stop when children go to 2ndary sch
Needs repeating 2 or 3 times pa
Cost – expensive (c£88 per child pa)

6. Health and Social Care Act 2012
Local authorities now responsible for consultations and decision-making on fluoridation schemes
Water fluoridation consultation regulations 2013 lay down procedures for local authorities to follow
Secretary of State now responsible for implementation of schemes and entering into formal agreements with water companies 6

7. Health and Social Care Act 2012
Similar processes, including public consultation for varying or terminating established schemes
Local authorities cannot just decide to terminate existing fluoridation schemes 7

8. Australian National Health & Medical Research Council, 2016
Benefits
There is consistent evidence that water fluoridation is associated with decreased occurrence and severity of tooth decay by 26-44% in children, adolescents and adults.
Australian National Health & Medical Research Council, 2016

9. PHE Water fluoridation health monitoring report for England 2014
Benefits
In fluoridated areas there are 48% fewer hospital admissions of children aged one to four for dental caries
PHE Water fluoridation health monitoring report for England 2014

10. Safety
‘The report provides further reassurance that water fluoridation is a safe and effective public health measure’
PHE Monitoring Report 2014

11. Safety
‘The current review shows that CWF within the current Australian range (0.6 to 1.0 mg/L) does not cause harm’
Australian NHMRC 2016

12. Steps for taking forward
PHE “Improving oral health: a community water fluoridation toolkit for local authorities” 2016
Sets out the legislation and step by step guidance

14. Targeted water fluoridation
Not every local authority needs water fluoridation
But areas with the poorest oral health would benefit greatly
Best estimate 25-30% of England (currently about 10%)
Particularly conurbations in North of England

15. Help and advice are available (PHE and BFS)
Take away message
Don’t put in the ‘too difficult box’!
Yes, it is challenging, hard work
But benefits to your community are great -
Especially to the most vulnerable sections of the community
Help and advice are available (PHE and BFS)

17. British Fluoridation Society