Celebrating 50 years of water fluoridation

Tap water

Tap water

A pioneering move by Birmingham City Council 50 years ago transformed dental health across the city, dramatically reducing the levels of tooth decay among children.

And delegates at a conference to mark 50 years of water fluoridation heard how the benefits of the 1964 decision are still being felt throughout Birmingham.

Opening the event, Council leader Sir Albert Bore told Health professionals, academics, dental students and politicians: “The introduction of water fluoridation in Birmingham helped transform children’s dental health. Of all the major cities in Britain, Birmingham led the way. Successive generations of children have been the main beneficiaries.”

Following the pioneering decision, the dental benefits for the city were significant. Figures from the Birmingham community dental health services showed that between 1965 and 1981 extractions of deciduous (first) teeth in children aged under 15 dropped from 35,000 to just over 9,000, and extractions of permanent teeth fell from around 11,000 to 3,500.

Over the same period, general anaesthetics for tooth extractions in under-15s fell from 18,000 to 2,000, whilst emergency dental visits because of bad toothache dropped from around 10,250 to 1,500.

A study reported in the British Dental Journal in 1971 found that in the six years following the start of fluoridation in 1964 tooth decay levels among children in the fluoridated Birmingham suburb of Northfield dropped by 46%, compared with a fall of just 2% over the same period among children in (then) non-fluoridated Dudley. In 1986, Dudley introduced a fluoridation scheme of its own.

Echoing Sir Albert’s comments, Birmingham cabinet member for health and wellbeing Councillor John Cotton said that as the first major city in Britain to introduce a water fluoridation scheme, Birmingham was rightly proud of its pioneering role in this important field of public health.

Director of Public Health Dr Adrian Phillips added: “Water fluoridation has been shown to be a safe and effective way of tackling the burden of tooth decay. The evidence suggests that it benefits socially deprived children the most and thus reduces health inequalities.”

Professor Rod Griffiths, a former President of the Faculty of Public Health of the Royal Colleges of Physicians, said: “As West Midlands regional director of public health from 1992 to 2004, I was satisfied that water fluoridation did not cause harm and that, on the contrary, it went a long way towards giving poor kids rich kids’ teeth.”

Recent surveys of children’s oral health across English local authorities have found that:

5-year-olds in fluoridated Birmingham have, on average, 34% fewer teeth affected by decay than those in non-fluoridated Manchester;

2-year-olds in fluoridated Birmingham have around 42% fewer teeth affected by decay than those in non-fluoridated Manchester.

Children aged 0 to 19 in the mainly non-fluoridated North West of England are also reported to be several times more likely to have decayed teeth extracted under a general anaesthetic in hospital than those in the mainly fluoridated West Midlands.

Professor Damien Walmsley, professor of restorative dentistry at the University of Birmingham Dental School and scientific adviser to the British Dental Association, stressed that fluoridation had saved many thousands of teeth from having to be filled or extracted. He added: “It has changed the face of dentistry in this city.”

Birmingham dental practitioner and secretary of Birmingham Local Dental Committee Eddie Crouch commented: “Dentists who are practising in Birmingham today can only imagine the levels of tooth decay they would have encountered over the past 50 years if the City Council had not backed water fluoridation. It really makes a difference.”