The Symposium was organised by the National Alliance for Equity in Dental Health (see list of supporting organisations), and chaired by Lord Tomlinson, President of the British Fluoridation Society.  The meeting was well attended by health professionals and policy makers – including the Chief Dental Officer, MPs and members of the House of Lords. 

·     Hazel Blears MP, Minister for Health, opened by re-iterating the Government’s strong commitment to reducing health inequalities, including oral health inequalities.  The Minister stressed that she considers teeth to be as important as the rest of the body and that good oral health and an attractive smile are essential components of general health and social development.  She highlighted the serious impact poor oral health can have on health and well being in terms of pain, reduced nutrition, impaired speech and language development and behavioural problems.  In addition, the Minister pointed out that reductions in tooth decay rates could make considerable savings for the NHS – she used the example that health authorities and trusts must now provide beds to administer general anaesthetics for dental extractions.   Minister argued that this money could better be spent elsewhere in the NHS.

 The Minister stressed the importance of properly consulting the public about water fluoridation and other health issues.  She pointed out that the review of water fluoridation undertaken by the University of York NHS Centre for Reviews and Dissemination had concluded that the best available evidence shows that water fluoridation is effective in reducing tooth decay rates, but had been critical of the low to moderate quality of much of the research.  The Government had therefore asked the MRC to make recommendations about future research needs.  The Minister said that the MRC Working Group on Water Fluoridation and Health is expected to submit its report to Government in Spring 2002 and that the Government would take forward the agenda from there as fast as possible. 

The Minister went on to outline a number of other Government initiatives aimed at improving oral health in the UK including the national Brushing for Life scheme and the introduction of fluoride milk in some UK schools.

The Minister believed that progress was being made but acknowledged that there is still a long way to go.  The Minister closed by reiterating her commitment to reducing inequalities in oral health, and expressed her wish to remain in close working contact with the National Alliance for Equity in Dental Health. 

During questions, members of the audience commented that measures such as the Brushing for Life scheme and fluoride school milk, whilst welcome, were likely to be inferior to water fluoridation in terms of their ability to impact upon dental health inequalities.  It was also pointed out that these measures could provide an additional benefit to a fluoridated water supply, but should not be considered as a substitute. 

·     Dr Evan Harris MP, Liberal Democrat Frontbench spokesman on Health, said that he was pleased to hear the Minister’s strong commitment to reducing oral health inequalities.  Dr Harris pointed out that he is personally a keen exponent of evidence-based medicine.   Dr Harris said that, given that the Government had commissioned the York CRD to review the evidence relating to water fluoridation, it had been the right course of action to subsequently ask the MRC to advise on future research needs.  Dr Harris expressed the view that we would be unlikely to see new fluoridation programmes in advance of any research proposed by the MRC, but stressed that the Government should fund and push through the research as quickly as possible. 

Dr Harris raised the question of how ultimately fluoridation would be implemented and argued that it is difficult to justify a targeted approach to a public health measure that is supported by the evidence as safe and beneficial.  Dr Harris agreed that the decision to fluoridate should not be taken by the water companies.  He also went on to stress that pressure groups campaigning against the evidence should not be allowed to veto local decisions. 

Dr Harris concluded by expressing his desire to see an equitable and rational approach to public health. 

·     Mr Stephen Hesford MP, Secretary of the All Party Primary Care and Public Health Group, opened by remarking that his Group has not yet addressed the issue of dental health but that he would like to see this included on their agenda.  

    Mr Hesford reminded the meeting that the Acheson Inquiry into Inequalities in Health had recommended water fluoridation.  Mr Hesford pointed out that the considerable resources put into improving oral health had so far failed to have any impact on the high rates of tooth decay in his own Wirral West constituency.  Mr Hesford referred to fluoridation as “the great equaliser” because of its ability to reduce social inequalities in dental health.

    Mr Hesford welcomed the Government’s commissioning of the MRC Working Group on water fluoridation and health, and expressed his hope that we would soon see progress on the issue so that communities could begin to benefit from a fluoridated water supply.

·     British Fluoridation Society Chairman, Professor Michael Lennon, launched a new briefing on inequalities in dental health based on the most recent national survey of the dental health of 5-year-olds.  He drew attention in particular to the 6-fold difference in the average number of decayed, missing and filled teeth (dmft) between the best and the worst health districts.  He went on to describe the effect that tooth decay has on the lives of young children living in poverty in terms of pain, infection and tooth extraction under general anaesthetic.

·     Lord Colwyn, British Fluoridation Society Vice President, made closing remarks.  He pointed out that despite successive Government’s support for water fluoridation, no progress has been made over the past 25 years.  Lord Colwyn argued that to reduce dental health inequalities, the Government needed to reduce the barriers to fluoridation and improve access to NHS Dentistry.  Lord Colwyn said that his background in complementary dentistry means that he understands the arguments put forward by opponents of water fluoridation, but went on to express his strong belief that the argument for reducing inequalities in dental health overrides these.

    Lord Colwyn said that the 1985 Water Fluoridation has failed and that, whilst the Minister’s earlier comments had been encouraging, he closed by saying “we know what needs to done, and Government should get on and do it”.

·     Following an interesting and lively question and answer session, Lord Tomlinson, closed the meeting by thanking all of the speakers and those who attended the Symposium. 

Copies of the new BFS briefing can be obtained from: Sheila Jones, Information and Research Officer, British Fluoridation Society, 5^th Floor, University of Liverpool School of Dentistry, Liverpool L69 3GN.  Tel: 0151 706 5216; Fax: 0151 706 5845; E-mail: bfs@liv.ac.uk; url: www.liv.ac.uk/bfs