Dental effects of fluoridation of water with particular reference to a study in the United Kingdom

Abstract

Plan of the studyFluoride is present, naturally, in almost all water supplies, usually in trace amounts, but in many parts of the United States it occurs in concentrations of between 1.0 and 8.0 p.p.m. It was in that country that most of the earlier research into its effect on dental conditions was done and that the beneficial effect of relatively low levels of fluoride in the drinking water was first demonstrated. As a logical extension of that research the idea was conceived of adding fluoride to some water supplies to see if the same beneficial effect could be obtained; accordingly in 1945 controlled fluoridation studies were set u p in two areas in the United States and in one in Canada.Fluoride was added to the water supplies in these areas to give a concentration of from 1.0 to 1-2 p.p.m., the level which epidemiological studies had shown to give maximum protection to the teeth without causing enamel mottling. T h e studies were planned to last for at least 10 years so that the effect of fluoridation during the whole period of development and calcification could be assessed on both the deciduous and permanent dentitions. Interest in fluoridation was aroused in this country by the results achieved in these studies after even 5 years. A mission was sent by the British Government to study fluoridation in operation and to assess its effectiveness, safety and practicability. T h e mission reported favourably (Ministry of Health, Department of Health for Scotland, Ministry of Housing and Local Government, 1953) but recommended that, before the general adoption of fluoridation, its effect should be demonstrated in a few selected areas in the United Kingdom. Accordingly studies were begun in 1955-6 in three areas in the United Kingdom. Selection of areasThe areas selected were: Watford in England, Kilmarnock in Scotland, and part of the county of Anglesey in North Wales. Three comparable areas were selected also, to serve as controls: Sutton, the town of Ayr and the remainder of the county of Anglesey respectively.T h e main criteria for the selection of areas were that ( I ) the population should be large enough to provide adequate samples of children; (2) the study area and its associated control area should be situated near to each other and be of the same character; (3) the pairs of study and control areas should be in different parts of the country so that the effect of fluoridation could be assessed in different environmental and dietary conditions; (4) the water supplies of each study area and of its control area should if possible be from the same geological sources and undergo the same https://www.cambridge.org/core/terms. https://doi

Control of Dental Caries in Children and Adolescents Using Fluoride: An Overview of Community-Level Fluoridation Methods

“…This led to the initiation of water fluoridation programs in various communities in the United States, with Grand Rapids, Michigan, being the first city to start a water fluoridation program in 1945 [ 27 , 28 , 29 , 30 ]. Other significant programs followed in other parts of the world, for example, in the United States, in Newburgh in 1945 and in Evanston, Illinois, in 1946; in Canada in Brantford, Ontario in 1945; in the Netherlands in 1953; in New Zealand in 1954 [ 31 ]; in the United Kingdom, the first substantial introduction was in Birmingham and a few other cities in 1964 [ 32 ]; and in the German Democratic Republic in 1959. Subsequently, extensive water fluoridation programs have been introduced in Australia, Brazil, Chile, Colombia, Canada, the Hong Kong Special Administrative Region of China, Ireland, Israel, Malaysia, New Zealand, Singapore, the United Kingdom, and other locations.…”

When evidence alone is not enough: the problem, policy and politics of water fluoridation in England

“…In December 1953 the government therefore invited a number of local councils to operate as testbeds for fluoridation projects, of which four accepted (Anglesey, Kilmarnock, Andover and Watford) (Whipple 2010:231). Subsequent research into the effectiveness of these trials (see Bransby et al 1963) provided 'clear evidence of the value of fluoridation as a preventative measure against dental caries' which when combined with studies from around the world provided 'massive evidence' for the extension of water fluoridation throughout the 1960s.…”

Inequalities in dental health: An ecological analysis of the interaction between the effects of water fluoridation and social deprivation on tooth decay in children living in England

“…Allegedly, according to much of the oral health policy developed in England, water fluoridation overrides the effects of social deprivation on dental health as fluoridation is a 'great equaliser'. This belief stems from evidence gathered in the first evaluation of dental effects of fluoridation in 1962 (Bransby et al, 1963), followed by more recent attempts in the late 1990's (Yeung, 2008;Mcdonagh et al, 2000) and to the present day (Mcgrady et al, 2012). This most recent evaluation, comparing two socially deprived populations in England, concluded that water fluoridation appears to reduce the social class gradient in dental caries whilst increasing the risk of fluorosis.…”