Flouride could be put in Cornwall's water supply to prevent tooth decay amid lack of NHS dentists

The measure has been proposed to tackle rising levels of tooth decay among children. Credit: LDRS

A consultation is likely to be held on whether fluoride should be added to Cornwall's drinking water in a bid to tackle rising levels of tooth decay.

It comes as people struggle to access NHS dental services.

Fluoride is a naturally occurring mineral found in water. It is also added to many toothpastes as it can prevent tooth cavities, reverse decay and stop the early loss of 'baby teeth' in children.

The amount of fluoride that occurs naturally in water varies from region to region. It is naturally low in the South West - below 0.1 milligrams per litre.

Cornwall Council's public health team believe it is now necessary to add fluoride to the supply of drinking water to help tackle what it described as "worsening" levels of tooth decay among children.

In England and Wales, less than 10% of the population have fluoride added to their water. The process is mostly found in water supplies in the West Midlands, North East and North West of England.

A report written by Cornwall Council's director of public health Rachel Wigglesworth says there is evidence of considerable benefits from water fluoridation on top of the use of fluoride toothpaste - and that the benefits are greatest in the most deprived areas.

But there is some controversy concerning the process, with some believing that it can lead to health problems, despite health professionals – including the four chief medical officers in the UK – stating it is healthy and safe.

In her report to Cornwall’s Health and Adult Social Care Overview and Scrutiny, Ms Wigglesworth says: "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."

Any costs associated with fluoridation would be covered by the Department of Health, not South West Water or Cornish taxpayers. Credit: PA

She added there is a "concerning" deterioration in children's oral health as they get older with 26.2% of year six children in Cornwall having dental decay. In the wider South West region, this figure is 12.1%.

"In the children examined 4.9% reported pain in their teeth often or very often which is concerning," Ms Wigglesworth said.

However councillors have been grappling with the ethical and philosophical implications of fluoridating the region’s water supply.

The Health and Adult Social Care Overview and Scrutiny committee was ultimately divided on whether to move forward with the fluoridation proposal, opting to request a consultation on the issue.

Cornwall Council's leader will now write to the Secretary of State to begin the process.

While some councillors supported the plan to add fluoride due to the proven benefits in fighting dental decay, others expressed ethical concerns over government-mandated water fluoridation.

Chairman Councillor John Bastin opened the meeting with a caution, saying, “Clearly there are different views on this, but we must respect each others’ views.”

He added that since the 1950s, 6.1 million people have been using fluoridated water and “if there had been serious health issues, such as gum disease or effects on IQ, surely we would see that evidence by now”.

Cllr Nicky Chopak voiced concerns about adding fluoride having an adverse impact on people's dental hygiene routines.

“If I was someone who struggled to afford very good toothpaste and a new toothbrush on a regular basis and I knew that fluoride was in the water, would I be thinking ‘well, I don’t need to worry about my little Johnny’s teeth because he’s going to be drinking a glass of water today?’," she said.

"There’s a bit of a mindset thing selling it to everyone that this is in addition not instead of.”

Cllr John Tivnan voiced his concerns about government overreach: “This is an imposition and that’s my stumbling block. I’m all in favour of anything that helps humans, but it is the individual’s decision and that’s being taken away from us and I’m a little bit concerned."

The council’s consultant in public health said there is reduction in tooth decay among five-year-olds in the 10% of the population that has a fluoridated water supply, with adults tending to retain more of their teeth than those living in areas where the water is not fluoridated.

Still, some councillors remained unconvinced. Cllr Jennifer Cruse questioned the ethics and effectiveness of fluoridation, suggesting resources might be better spent on educational initiatives in schools: “I’ve spoken to quite a few of my residents – there wasn’t one who wanted it,” she said.

“What we may decide will be taking away the choice of the adults.”

Cllr Andy Virr, portfolio holder for health, supported the measure, calling it “absolutely the right thing we should be doing in Cornwall. The people who will benefit most are members of society who have less choice because of their poverty.

"You may think this is a nanny state intervention, but there is a role for state intervention. The sugar tax on fizzy drinks has made a big impact on dental caries [decay] already.”

With opinions divided, a motion to advocate for fluoridating Cornwall’s water supply did not receive a seconder and was dismissed.

However, the committee passed a second recommendation for Council Leader Linda Taylor to request a consultation on fluoridation from Secretary of State for Health Wes Streeting.

The meeting also clarified that any costs associated with fluoridation would be covered by the Department of Health, not South West Water or Cornish taxpayers, should the proposal move forward.

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