Report No FR0293

March 1992

There has been controversy over whether the fluoridation of water supplies is necessary or even desirable ever since the practice was first introduced in the 1940s. Opposition to fluoridation has primarily been due to a moral issue of personal choice. Some opponents also claim it causes adverse health effects or question the benefits of fluoridation, claiming the reduction in tooth decay is greatly exaggerated. However, there is good evidence that the recommended level of 1 mg fluoride/1 in drinking water causes significant benefits in the reduction of dental caries. Furthermore, there is no convincing evidence of any adverse health effects for consumers at this dose. However, where accidental overdosing of water supplies has occurred, fluoride levels have been measured at or above 30 mg/1.

If fluoridation is carried out, the optimum level should be determined by local circumstances, such as the natural level of fluoride in the local supply waters, ambient air temperature and the probable intake from other dietary sources. Currently, fluoridation remains unpopular in Western Europe and is banned in Sweden and the Netherlands. However, other countries such as the Republic of Ireland and the USA support and recommend water fluoridation. Presently in the UK, water suppliers are empowered to fluoridate water supplies if requested to do so by their local Health Authority, and the UK Government seeks to encourage water fluoridation. A consultative document on dental health strategy, including fluoridation, was due to be published after the issue of the Government's White Paper on the Health of the Nation, but the issue of both documents has been delayed by the General Election.

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