THE
NATIONAL ALLIANCE FOR EQUITY IN DENTAL HEALTH
Submission to the House of Commons Health Select Committee Inquiry into Public
Health.
4 July 2000
- The National Alliance for
Equity in Dental Health is a consortium of more than 40 medical,
scientific and voluntary organisations campaigning to extend water
fluoridation to improve the dental health of the UK's
most vulnerable children (See attached list
of supporting organisations).
- One of this government's
prime objectives is to reduce health inequalities.
- The Government commissioned
an independent systematic review of the safety and benefits of water
fluoridation. The review is being conducted at the University
of York's NHS Centre for
Reviews and Dissemination. Preliminary results confirm that fluoridation
reduces dental health inequalities both between fluoridated and
non-fluoridated districts and, importantly, significantly narrows the
dental health 'gap' between young children living in poverty and their
more affluent peers.
- Furthermore preliminary
draft results confirm the current scientific position - in particular that
fluoridation is safe. There is no evidence that water fluoridation is
linked to cancer, bone disease, or any other adverse effect.
- In 1976 Barbara Castle as
Secretary of State for Social Services in the Labour government published
a consultative document1 stressing for the first time in the
reorganised health service that "the preventive approach should
permeate and inform all aspects of the health services."
- The document said that
dental health provides "a dramatic illustration of regional and
socio-economic differences". That statement remains true today.
- The document said that
"very few preventive measures are as effective or are so easy to
implement as the fluoridation of water supplies …(it) has been
established beyond doubt as being completely safe and the most effective
method of reducing the incidence of dental caries in the community.
… Yet of all recent initiatives in preventive medicine this has been
in Britain,
though not in other countries (e.g. the United
States, Canada,
the Republic of Ireland)
the most disappointing." That statement remains true today .
- The document highlighted
fluoridation as a highly cost effective public health intervention. That
remains true today.
- The 1980 Black Report2
highlighted the evidence that "working-class people make less use
of dental services". The 1987 and 1992 versions of The Health
Divide3 highlighted the fact that though dental health had
shown a marked improvement over the previous 20 years, more adults in
lower social groups had no natural teeth than in more affluent groups, and
5-year-olds in manual classes had on average twice as many decayed teeth
compared with those from non-manual classes. Again, this remains true
today.
- More recently, Sir Donald
Acheson's Independent Inquiry into Inequalities in Health4
recommends the fluoridation of the water supply based on its proven
efficacy in reducing persisting inequalities in dental health.
Summary and recommendation
Inequalities in dental health in the UK
remain wide. Water fluoridation produces a guaranteed, measurable reduction in
these inequalities in the youngest and most vulnerable children. This Alliance
recommends the early introduction of legislation to ensure that health
authorities are no longer prevented from implementing water fluoridation
schemes where there is both need and local public support.
1Health Departments of Great
Britain and Northern
Ireland (1976): Prevention and health:
everybody's business. A reassessment of public and personal health. HMSO. London.
2Black, DAK: Inequalities in Health: report of the working group
on inequalities in health. 1980. DHSS, London.
3Whitehead, M: The Health Divide: Inequalities in health in the
1980s. 1987. Health Education Council, Wembley.
4Acheson, D: Independent Inquiry into Inequalities in Health
Report. 1998. HMSO, London.
Sheila Jones MPH
Co-ordinator, National Alliance for Equity in Dental Health
C/O University of Liverpool
School of Dentistry
Liverpool L69 3GN
BFS
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