U.K. water fluoridation cuts hospitalizations for tooth decay

A new U.K. report has found that children living in areas with water fluoridation have less tooth decay and fewer hospitalizations than those living in areas without water fluoridation.

As many as 45% fewer children ages 1 to 4 in fluoridated areas, where the level of fluoride is 1 part per million, are hospitalized for tooth decay -- primarily to have the teeth extracted under general anesthesia -- than in nonfluoridated areas, according to the report issued by Public Health England (PHE), an agency of the Department of Health.

The following are key findings from the report:

• When deprivation and ethnicity -- both important factors for dental health -- are taken into account, 28% fewer 5-year-olds have tooth decay in fluoridated areas than nonfluoridated areas.
• When deprivation and ethnicity are taken into account, 21% fewer 12-year-olds have tooth decay in fluoridated areas than nonfluoridated areas.
• The reduction in tooth decay in children of both ages in fluoridated areas appears to be greatest among those living in the most deprived areas.

The PHE also found no differences between fluoridated and nonfluoridated areas in their rates of hip fracture, osteosarcoma, cancers overall, Down's syndrome births, or all-cause mortality.

In fact, rates of kidney stones and bladder cancer were lower in fluoridated areas than nonfluoridated areas, according to the report. Although the PHE cautions that this should not be interpreted as a "protective effect" from fluoridated water, as the lower rates may be due to other factors, the possibility that they occurred by chance cannot be ruled out.

"This report provides further reassurance that water fluoridation is a safe and effective public health measure," said John Newton, chief knowledge officer at PHE. "We will use this report as a basis for discussions with local authorities on the scope and content of further reports and on the role of fluoridation as a public health measure."

The PHE was established in April 2013, and this is its first report on the health of people living in fluoridated areas. It is required by legislation to produce them every four years on behalf of the secretary of state for health

"It is notable that the benefits of this public health measure appear to be greatest for children living in the most deprived areas of the country," said Sue Gregory, director of dental public health at PHE. "This is significant for reducing the large differences we see in dental health between deprived and more affluent areas of the country."