Water Fluoridation is commonly regarded as one of the most effective health advancements in recent decades. Studies have consistently shown the benefits of water fluoridation to oral health. However, with fluoride commonly found in other products, can governments and policymakers justify the costs of further water fluoridation projects? Now, new research has tackled this topic.
Recent research has looked into the impact of Water Fluoridation programs in England. This includes both existing programs, and potential projects in the future.
The research suggests that while existing water fluoridation programs help to save money, there is no guarantee that future schemes will follow the same pattern [1].
This is an interesting finding, with water fluoridation a topic that elicits differing responses from many nations. These findings may help to guide future government policies.
What is Water Fluoridation?
Water Fluoridation refers to the process where a small amount of the natural chemical Fluoride is added to the public water supply. Numerous studies have shown that water fluoridation is associated with a reduction in cavities [2].
However, water fluoridation has also proven to be a controversial topic. Many countries have banned its practice outright, citing ethical concerns, and the potential dangers to over-exposure to fluoride.
This research took place in the United Kingdom. Approximately 11% of those living in England live in areas with water fluoridation schemes [3]. Therefore, the majority do not. The cities of Newcastle and Birmingham are among the largest areas to have water fluoridation schemes [3].
As the majority of research into water fluoridation was conducted prior to fluoride being added to toothpaste in the 1970s, it has been argued that more contemporary research is needed.
The Research
The research was carried out by the University of Manchester. Their findings have been published in the Community Dentistry and Oral Epidemiology journal [1].
Their research forms the largest ever study into the effects of water fluoridation on the dental health of adults [1]. In England, the majority of people access their dental care through the National Health Service (NHS).
The research involved looking at 6.4million adults and adolescents living in England [1]. Across these millions of adults, some lived in areas with fluoridated water, while others didn’t.
This created two cohorts. The researchers looked to see how patients in each cohort reacted over a 10-year period. Furthermore, this involved looking at areas like fillings, teeth extractions, tooth decay and missing teeth [1].
Overall, the findings were largely positive in respect to water fluoridation. Over the 10-year period, areas with water fluoridation cost £10.30 per person on average [1]. Moreover, NHS treatment costs were £22.26 lower per person – representing a 5.5% reduction compared to those in areas without water fluoridation [1].
Moreover, patients in fluoridated areas paid marginally less in dental charges. Unlike the majority of the NHS, dental care is not free in the UK. On average, those in fluoridated areas paid £7.64 less than their counterparts in non-fluoridated areas [1].
In locations where water fluoridation was in operation, there was a 3% reduction in NHS invasive dental treatment like fillings and extractions [1]. Moreover, there was a 2% reduction in decayed, missing, and filled teeth [1]. These reductions were in comparison to a group of people that lived in non-fluoridated areas over the 10 years.
The researchers came to the conclusion that the public sector saved £16.9million between 2010 and 2020 due to water fluoridation [1]. This presents large savings to the NHS.
Are the benefits worthwhile for the future?
Based on the findings, it could be argued that water fluoridation is worthwhile, and that further water fluoridation programs should take place.
However, the NHS needs to take cost into consideration, and may need to judge if the outlay required for further water fluoridation programs can be justified based on cost savings.
For example, while there were benefits to those in fluoridated areas, these improvements were rather marginal. Therefore, it is questionable as to whether or not these modest improvements can justify the expenditure involved.
A new water fluoridation scheme that would replicate similar programs from 2009 would cost approximately £50million. Therefore, based on this research, it would take around 30 years for the NHS to experience any savings [1]. This represents a significant time period.
It has also been argued that people have more access to fluoride through toothpastes and mouthwashes in the present day. This also adds to the suggestion that water fluoridation programs are not entirely needed for future generations.
Summary
Water fluoridation has been hailed as one of the most important health advancements in recent decades. There are many benefits to it, despite some opposition to it.
But water fluoridation isn’t enough on its own. Excellent oral hygiene and regular check-ups are needed. After all, there have been concerns from dentists over tooth decay levels.
For example, lead author Dr. Deborah Moore – from the University of Manchester – has said that “tooth decay remains almost universal by adulthood, even in populations that have had access to fluoride toothpastes and fluoridated water from birth” [4]. Therefore, even those in fluoridated areas are still able to develop tooth decay.
Overall, while existing water fluoridation programs in England provide marginal savings for the NHS, there is no guarantee that new schemes would continue to provide such cost savings. This represents an interesting dilemma for health professionals and policymakers going forward.
Thinking points…
[1] While the addition of fluoride to toothpaste and mouthwash products has helped to protect against cavities, we all need to ensure we have excellent oral hygiene! This includes attending regular dental check-ups, as this provides your dentist with the chance to examine your mouth, provide advice, and suggest treatment if needed. You should attend the dentist at least twice per year. We recommend booking an appointment now!
[2] Do you know if the area you’re in has fluoridated water? It can be interesting to find out! Why not have a discussion about the topic with those around you to see how everyone feels towards its practice? Feel free to share this article with your friends and family to start a discussion! You could also speak about it to your dentist if you need further advice.
What we offer at Savanna Dental
Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice, with the aim of improving oral health and boosting overall wellbeing!
We advise our patients to attend our Calgary dental clinic at least twice per year for a regular dental check-up. At these check-ups, we provide a comprehensive review of a patient’s oral health. If any problems are detected, we have many treatments available. For example, these include cavity fillings and root canals. To strengthen your oral health, we recommend brushing your teeth at least twice a day and flossing regularly.
Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, teeth whitening and Invisalign™! Our patients find that these treatments have a positive impact on their appearance, confidence and self-esteem.
Moreover, the fees of our treatments at our Calgary dental clinic Savanna Dental are set in line with the Alberta Dental Fee Guide. This ensures transparent and fair pricing, with no hidden costs.
We hope to see you soon at our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.
References
[1] Moore, D., Nyakutsikwa, B., Allen, T., Lam, E., Birch, S., Tickle, M., Pretty, I. A., & Walsh, T. (2024). How effective and cost-effective is water fluoridation for adults and adolescents? The LOTUS 10-year retrospective cohort study. Community Dentistry and Oral Epidemiology. (Pre-publication issue).DOI: https://doi.org/10.1111/cdoe.12930.
[2] Slade, G. D., Grider, W. B., Maas, W. R., & Sanders, A. E. (2018). Water Fluoridation and Dental Caries in U.S. Children and Adolescents. Journal of Dental Research. 97 (10): p1122-1128. DOI: https://doi.org/10.1177%2F0022034518774331.
[3] Department of Health & Social Care. (2022). Health and Care Bill: water fluoridation. Available: https://www.gov.uk/government/publications/health-and-care-bill-factsheets/health-and-care-bill-water-fluoridation. Last accessed: 17th January 2024.
[4] Addelman, M. (2024). Future benefits of water fluoridation not guaranteed, study shows. Available: https://medicalxpress.com/news/2024-01-future-benefits-fluoridation.html. Last accessed: 17th January 2024.
