Level up our children’s dental health

By Ray Lowry

Level-up with oral health: How the North East led the way with a much- forgotten intervention

Levelling up is not just a matter of economics. It is also about health, including dental health. Some parts of the North East have led the way, but there are other places where action is still needed, and there is now an opportunity to take it which must not be squandered. Dr Ray Lowry, who is a retired consultant in both public health and dental public health and secretary of the British Fluoridation Society, explains the background.

The story started on the banks of the River Tyne in the North East of England in the 1940s.

To protect children from the anticipated bombing of industrial Tyneside, they were evacuated to the other side of the country, to the Lake District. The senior school dentist for Westmorland examined the evacuated children and noted that some of them had better teeth than the locals. When he enquired, he found that the ones with the good teeth came from South Shields. The others, with teeth as bad as the locals, came from across the river in North Shields.

Once analysed, it was found that South Shields drinking water contained what we now know to be enough natural fluoride to provide maximum protection from dental decay. The fluoride content of the drinking water made a big difference to the decay experience of children on either side of the Tyne and the country. For doctors and dentists, this was era when the potential of water fluoridation (deliberately adjusting the fluoride content of drinking water) dawned as a public health measure in the UK.

Parts of the North East have now had fluoridated water for 50 years, including Newcastle and Gateshead, but people in other places, including most of Northumberland and Durham, are still missing out, with the resulting pain and misery for thousands of children. Fluoridation plans for these areas are on the cusp of being implemented, but there is a real danger that if the government takes its eye off the ball now the opportunity will be lost.  

This parochial story has a wider resonance. The early promise of an end to dental decay as witnessed in South Shields has not been translated country-wide. Some six million people in the UK (a tenth of the population) benefit from a fluoridated water supply. While dental health has improved through other factors, such as fluoride in toothpaste, the water fluoridation dividend has largely been withheld, especially where most needed.

To level-up the oral health of the region and the nation, water fluoridation ought to be implemented across the UK. The legislation and experience are there. Just the will to do it is missing.