§ Mr. EtheringtonTo ask the Secretary of State for Health (1) which(a) water authorities and (b) water companies have rejected health authorities' requests for fluoridation since 1985 indicating where these have been on (i) non-technical and (ii) technical grounds; [29135]
(2) what estimate he has made of the savings in dental health costs to Sunderland health authority from water fluoridation; [29132]
(3) when his Department last discussed fluoridation of water supplies with (a) the NHS Executive, (b) the Water Services Association and (c) the Water Companies Association; [28990]
(4) if he will give the total number of cases since 1986 of dental fluorosis in each of the district health authorities in the Northern and Yorkshire region indicating which DHA has (a) artificial fluoridation and (b) natural fluoridation; [29138]
(5) what are the estimated annual projected (a) capital and (b) revenue costs to Sunderland health authority from water fluoridation; [19133]
(6) what research his Department has (a) undertaken and (b) commissioned regarding the relationship between the incidence of tooth decay in areas of similar income level which (a) have and (b) do not have fluoridated water supplies. [29139]
§ Mr. MaloneSunderland is naturally a fluoridated area 481W with 87 per cent. of the population receiving water with a natural fluoride content between 30 per cent. and 70 per cent. of the optimum concentration for dental benefit. There are no revenue or capital costs associated with natural fluoridation at the level found in Sunderland. No estimate has been made of the savings this has made in dental health costs to Sunderland health authority. Studies have shown in general, however, that the incidence of caries can be reduced by as much as a third to a half in fluoridated areas compared with non-fluoridated areas.
A number of studies and surveys have been carried out since 1990 showing the effect of water fluoridation on dental caries in five-year-old children in communities of differing socio-economic groups. These are listed, with the relevant technical references, in the publication "One in a Million" published in 1994 by the British Fluoridation Society and the Public Health Alliance. This publication is available in the Library. Some of the studies have been commissioned by the British Fluoridation Society, which is funded by the Department of Health. The Department has not itself, however, directly undertaken nor commissioned such studies as information is already available. A recent study into the effect of fluoridation and social class on caries experience in five-year-old Newcastle children in 1994 compared with results over the previous 18 years, showed that differences between the fluoridated and non-fluoridated areas were observed in all social class groupings but the greatest difference in the percentage of children with decay experience occurred in social groups IV and V.
Figures on the number of cases of dental fluorosis in each district are not collected. Officials are currently in correspondence with both the Water Services Association and the Water Companies Association about new guidelines to be issued to health authorities on water fluoridation. Since 1985, the English water undertakers which have rejected fluoridation requests by health authorities have been North Western Water, Yorkshire Water and Southern Water. None of these rejections was on technical grounds.