Word of Mouth - March

WordofMouth ISSUE 05 / MARCH 2013

Healthy Life, Healthy People: Fluoride

Kick the habit for the children’s sake

BRITISH DENTAL HEALTH FOUNDATION 2013

WordofMouth Contents

David Westgarph

davidw@dentalhealth.org

DR NIGEL CARTER OBE Chief Executive of the British Dental Health Foundation

04 Stub out those mood swings

10-11 School meals

05 Kick the habit

12 Oral health is the key

06 Appearance is key reason

13 Lifestyle survey

07 Word of mouth

14 - 15 Inventor mum

08-09 People die from a toothache?

16 - 17 Fluoride

Cutting out smoking could help you to relax

Kick the habit for the children’s sake

Appearance as the key reason to quit smoking

Word of mouth strengthens oral health

Bridge2Aid’s Mark Topley in Tanzania.

Why are they so important?

Oral health key to call to action

Lifestyle survey ‘encouraging‘ , charity claims

Dental industry accolade for inventor mum

Healthy Life, Healthy People.

Hello and a warm welcome to the March issue of Word of Mouth magazine.

I would firstly like to wish everybody a happy World Oral Health Day, the theme of which for this year is ‘Healthy Teeth for Healthy Life’ – a message that reflects the major contribution oral health makes to our lives. The day is a great opportunity to spread awareness and helps remind others that healthy teeth, gums and mouth play a crucial role in many aspects of our lives, from building relationships and generating self-confidence to preventing disease and maintaining the health of our whole body.

Although the prevention of oral diseases in the UK is increasing, there are many areas of the world where they are all too common.

In this issue of Word of Mouth we have Bridge2Aid’s CEO Mark Topley discussing dental decay in Tanzania, where people are still dying from tooth decay.

WordofMouth Editor David Westgarth

Also included in this issue are a variety of articles on smoking and oral health, to tie-in with this year’s No Smoking Day drive. One of these features the new “Don’t Go Cold Turkey” campaign, that ensures smokers who want to quit are aware of the help available to them and understand how taking the right approach can significantly increase the chances of successfully kicking the bad habit.

We also discuss school meals and tackle the question of inequalities in deprived areas where children may rely on the school meal as their main source of nutrition. And finally, I lend my thoughts up the upcoming change in powers on April 1 from Strategic Health Authorities to Local Authorities and what it could mean for the future to the addition of fluoride in drinking water.

I hope you enjoy this issue of Word of Mouth, and have a great World Oral Health Day too!

Art Director Doychin Sakutov

Guest Writers David Arnold Mark Topley Marian Greally

Educational Resources Amanda Oakey Becky Sollis

Cutting out smoking could help you to relax, as regular smokers are more likely to develop mood and anxiety disorders.

New research suggests the traditional belief among smokers that their habit helps to relax them may not be entirely accurate.

The research, published in the American Journal of Public Health, shows one in seven (14.2 per cent) of those aged 18 to 49 experienced new mood or anxiety disorders, while one in eleven (8.9 per cent) people aged 50 or over experienced new symptoms.

If a person is under a lot of stress, they will often have a difficult time cutting cigarettes out. If a person is a former smoker, it is most likely they will start smoking again in response to a stressful situation or bad mood.

Statistics4 show that people who are depressed are twice as likely to smoke as those who are not.

Most smokers learn to use cigarettes as a method of dealing with stress in their lives. When things are stressful, they reach for a cigarette. You will often hear them say that it calms them down. People who tend to be sad, tense, angry, or even bored, will reach for a cigarette when something triggers one of these emotions.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, thinks the research could prove to be a useful guide for the Government, local authorities and anti-smoking campaigners in knowing who to target.

Dr Carter says: “This research has given anti-smoking campaigners a very specific idea of who they can target. Previously it has been suggested that smoking relives the tension many people feel. I am sure we all know a smoker who is more irritable when they haven’t had a cigarette for a lengthy period of time.

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Stub out those mood swings

Kick the habit for the children’s sake Smokers are most likely to kick the habit due to the effect it has on children, according to the results of a new survey.

“As this research appears to point to regular smoking causing mood and anxiety problems, it is yet another reason for those considering taking up the habit to think again.

“Tobacco use is also the leading risk factor for developing mouth cancer. Smoking helps to transforms saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous. If you are a smoker, or if you drink alcohol to excess, have a poor diet, have the human papilloma virus (HPV), often transmitted via oral sex, you could be at risk from developing a disease that kills one person every five hours in the UK. The Foundation’s advice is simple – if in doubt, get checked out.”

Dr Mike Knapton, Associate Medical Director at the BHF, said: “One of the biggest incentives for smokers to quit comes from considering the real amount of money they spend on cigarettes and thinking about what themselves and their family could afford if they were to give up for good.

“By tallying up the exact amount of money that could be saved, smokers can work towards an actual goal – be it a new pair of shoes, a family trip to the cinema or a dream holiday.”

Almost a third (30 per cent) of those surveyed by the British Dental Health Foundation said they would stop smoking due to the effects it has on children.

More than one in four (26 per cent) said the danger of developing mouth cancer would be the reason they quit, while less than one in five (19 per cent) said the risk of lung cancer.

in the UK that want to quit do so sooner rather than later.

Children are often exposed to second-hand smoke in the home and particularly cars. Public Health Minister Anne Soubry has already called for smoking to be banned in cars carrying children on “child welfare” grounds.

“Tobacco use is still the leading cause of mouth cancer, a disease that claims more lives than cervical and testicular cancer combined. Through campaigns such as Mouth Cancer Action Month in November, it is vital people take the warnings about smoking on board and swap their fags for swag.”

Children are particularly vulnerable to the effects of second-hand smoke and exposure increases the risk of cot death, glue ear, asthma and other respiratory diseases.

A review by the British Medical Association’s Board of Science concluded that there is no safe level of exposure to tobacco smoke for children and adverse effects can be found at low levels of exposure.

Tobacco use is a major killer worldwide, and Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation, hopes the one in three smokers

Dr Carter said: “The research is clear-cut – smoking in any environment is harmful to you and those around you. Around one in six adults in the UK still smoke, and if they are doing so around their children it could have a catastrophic effect on their future health.

“Children see their parents as role models. If they are smoking, children are more likely to take up the habit. By stubbing out cigarettes now, not only will you stop damaging your body, you will stop damaging those around you.

The poll also revealed around one in ten (11 per cent) would stop smoking due to graphic advertising, although preventable oral health problems such as stained teeth and gum disease (seven per cent) had less of an effect.

Dr Carter added: “Smoking causes people to have more dental plaque and for gum disease to progress more rapidly than in non-smokers.

The best way to ensure you keep your mouth as healthy as possible is to quit smoking.”

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Appearance is key reason to quit One in seven smokers (14 per cent) who want to kick their habit agree that comments about their appearance have contributed to them feeling ready to quit for good1a.

The average smoker has tried to quit four times1c before, with nearly one in ten (nine per cent) having tried ten or more times.1d Despite repeated failure, 45 per cent1e of smokers think about giving up every day, with almost a quarter (24 per cent1f ) thinking about it five times a day or more.

The new research, consisting of an online survey of 6,271 current or former smokers, commissioned by Pfizer Limited to support its “Don’t Go Cold Turkey” awareness campaign, shows almost a quarter of smokers (23 per cent1b) said they would be more likely to seek help from a health care professional (HCP) if they knew it would increase their chances of success. Research has shown getting help from a healthcare professional can increase the chances of success by up to four times, compared to going it alone2.

Dr Sarah Jarvis, medical broadcaster and practising GP, says: “As a GP, my main aim is to get people to look at leading healthier lifestyles and one of the most important lifestyle change is stopping smoking. I’m aware that the vast majority of people who do smoke are either desperate to quit or have tried and failed in the past. I want those who are motivated to quit to consider that there is support available and that by speaking with their healthcare professional or local stop smoking service, they can increase their chances of success by up to four times, compared to going “cold turkey”.

The “Don’t Go Cold Turkey” campaign aims to ensure smokers who want to quit are aware of the help available to them from their healthcare professional and understand how taking the right approach can significantly increase the chances of successfully breaking the cycle of nicotine dependence. Visit www.dgct.co.uk for more information and advice on quitting smoking.

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References

1a. (question 9). From OnePoll’s online survey panel.

A total of 6,271 UK adults aged 18+ were asked a filter question to identify smokers who have successfully quit smoking and those who want to quit but are still smoking.

Across this overall sample, quota controls were by age, gender, region and by a split of the filter question to ensure a representative profile of the audience. From this 6,271 1b. From OnePoll’s online survey panel (question 20).

1c. From OnePoll’s online survey panel (question 1).

1d. From OnePoll’s online survey panel (question 1).

1e. From OnePoll’s online survey panel (question 2).

1f. From OnePoll’s online survey panel (question 2).

2. Department of Health. Local stop smoking services – service delivery and monitoring guidance 2011/12. 2011.

Available from: http://www.dh.gov.uk/prod_consum_ dh/groups/dh_digitalassets/documents/digitalasset/ dh_125939.pdf. Last accessed: 2nd November 2012.

Word of mouth

strengthens oral health

More than 28 million people in the UK chose their current dentist through word of mouth, according to new research.

In a poll conducted by Bray Leino, approaching half of people questioned (44.7 per cent) used friends and family recommendations for choosing their current dentist, while only 7.5 per cent of people used the internet. Almost two thirds (63.7 per cent) would rely on recommendations from friends and family to choose a new dentist.

The trust people have in their dentist was also highlighted as the survey found that two in every three people (66.3 per cent) would prefer to see the same dentist every time they visit.

To coincide with World Oral Health Day on 20 March, Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, suggests the research points to a stepping stone for the public to improve their oral health.

consent, giving the patient full control over their decision.

“The research shows the most successful way of finding a dentist involves nothing more than a few conversations with friends.

That element of trust people have in their dentist is reassuring, and could result in vast improvements in oral health over time.

“Barriers such as cost, fear and access really aren’t viable reasons for not finding a dentist. Prevention in the form of regular check-ups will ensure you don’t have to have expensive restorative treatment when something goes wrong.

Check-ups start from £17.50 so there is really no excuse.

“The significant advances in technology give nervous patients the reassurance they seek when paying a visit to their dentist, perhaps for the first time in a long time.”

Dr Carter said: “World Oral Health Day is a really good opportunity to find a dentist. Personal recommendations are a huge part of everyday society, from the restaurants we visit to the films we watch. The research shows this is the same for the dentists we use, which is very reassuring.

Tony Reed, Executive Director of the British Dental Trade Association (BDTA) said: “New technologies have transformed the whole experience of visiting the dentist. There are now a wide range of largely non-invasive treatments including laser treatments, to target decay and disease, and digital scanning technology which allows dentists to make replacement teeth and crowns without taking silicon impressions.

“If trust underpins the reason behind our choice of dentist, it becomes easier for the dentist to openly discuss the full range of treatments with patients. Resources such as the Foundation’s Tell Me About leaflets which can also be accessed at www.dentalhealth.org are a great way for dentists to back up their discussion with informed

“Dental treatments have advanced significantly helping to make a visit to the dentist a much more relaxed experience and encouraging more patients to take care of their oral health which, in turn, benefits their overall health. World Oral Health Day acts as a reminder of the importance of oral health and regular dental check-ups.”

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Dying

decay

It is 2013 and people are still dying from untreated dental decay. Two of our teams have just returned from the regions of Musoma and Bukoba in Tanzania, where for 10 days they have been training local health workers in emergency dentistry. They will train them in areas without running water or power, or the standard sterilisation kit we are used to here back in the UK (special charcoal-burning sterilisers are used instead). Yet for thousands of people living in distant, rural settlements there are now a dozen locallyqualified people who are able to treat their communities day-in, day-out, helping to prevent the sort of hideous conditions that my dinner companion had mentioned.

Surely people don’t die from a toothache?

Dying from simple dental decay might seem impossible, but on the eve of World Oral Health Day Mark Topley points out that – in some parts of the world – it is all too common.

I run a British dental health NGO out in Tanzania. At a dinner recently on the shores of Lake Victoria, I sat next to an America surgeon visiting the area. As well as working within our local city, Mwanza, she was carrying out surgery in one of the district hospitals where our emergency dental training teams are based. As we chatted, the subject turned to the training we’d been providing in the Lake Zone.

Although I knew that complications from untreated dental disease could cause real problems for people living in this part of the world, the comments my dinner companion made shocked me. Many of her patients, she said, needed major surgery to remove diseased tissue caused by untreated dental infection. As she explained,

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when a dental infection fails to ‘drain’ properly, the infection can track into the neck and then spread from there into the chest.

This leads to tissue necrosis (tissue death) and septicemia (severe infection in the blood), often fatal. Treatment is to cut away the necrotic tissue and give high doses of antibiotics.

Sadly, she reflected, this very rarely works. Once a person has infection tracking into their neck, the prognosis is not good. It was one of the enduring memories, and frustrations, from her visit. She summed it up with a comment at the end of dinner: “If I had my way, I would train an army of people to take teeth out safely. What people need in the villages round here is someone who can simply remove a diseased tooth, and stop the infection spreading.”

Sadly, however, the shocking reality is that three-quarters of the world’s population have no access to even the most basic of dental services. Dental Caries as the dental profession calls them – or tooth decay – is the world’s most common disease. It causes debilitating pain and drastically affects a person’s ability to function.

Most developing countries don’t have enough dentists: here in Tanzania there is one dentist for approximately every 100,000 people (in the UK the ratio is 1:2,500). In Rwanda, where we are about to launch a new project, there are just 11 dentists for the entire country! To make matters worse, these dentists usually live in cities and large towns, where in these east African nations only a minority of the population is based. This lack of access to pain relief leads to chronic suffering, the loss of ability to work or support the family, withdrawal of children from school (to help support subsistence farming), and complications that can and do lead to death.

So the access to a dentist in every village remains a utopia. What we believe is necessary, and where we feel our partnership with the Tanzanian government is leading the way, is to train medical personnel already deployed to these rural areas to provide a basic, pain-relieving service, combined with oral health education.

We’re extending that partnership elsewhere in Africa now, backed by the support of many British dental professionals.

Above all, though, all of us involved in this field must focus on relieving dental pain through training, so that local medics can carry out safe tooth extractions. Otherwise, literally, a toothache can kill.

Mark Topley is CEO of Bridge2Aid, a British dental health NGO operating in East Africa www.bridge2id.org | @mark_topley

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Key aims of International School Meals Day Raise awareness of the importance of the nutritional quality of school meal programs worldwide Emphasise the connection between healthy eating, education and better learning Connect children around the world to foster healthy eating habits and promote well-being in schools Share success stories of school meal programs around the globe

written by

David Westgarth

School meals – why are they so important?

I

remember when I was at school the content of my packed lunch wasn’t an issue. The only issue I had was getting more into it, and I’m not talking about apples, bananas or pears.

I also remember the dinner ladies were particularly fearsome. You had to finish your lunch or else they’d put you in lunch jail (they didn’t, although it felt like it. And my parents were never too happy with me bringing food home).

For me, school meals were a no-no. They always looked like mash potato and tasted like chicken, even if they weren’t. Packed lunches were a safer option, and as such my parents had free rein on what they could pack me off to school with.

Fast forward 20 or so years and the landscape has completely changed. Jamie Oliver marched to Downing Street on the back of a major petition over the standard of school meals. It certainly acted as a catalyst and a wake-up call for the campaigns and calls-to-action you read in the press and see on TV on an ever increasing basis.

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As if to signify the change in attitude over what today’s children consume at school, the first ever International School Meals Day took place earlier this month. Since 2010 both sides of the Atlantic have shared examples of policy and good practice on how to promote healthy eating in schools, and so International School Meals Day was born.

Backed by a number of global organisations including the British Dental Health Foundation, bringing the issue of good nutrition for children to the fore has multiple health benefits for children. Obesity is at an all-time high, and the level of tooth decay in children shows no sign of abating.

I spoke to Dr Nigel Carter OBE, Chief Executive of the British Dental Health Foundation, who said: “School meals can be extremely hazardous to oral health, particularly if parents

Highlight research activities in school meal programs around the globe Raise awareness of the hunger and poverty issues being addressed through school feeding programmes

are happy to satisfy their child’s sweet tooth and send them to school with fizzy drinks, sweets and chocolate bars. Children aren’t born with a sweet tooth, it’s picked up over time due to their early years diet.

“School meals have in the past been criticised for being unhealthy, and that is why International School Meals Day is a great way to bring the issue to light.

Meals have significantly improved over the last 10 years, yet there is always more we can do.

“The odd chocolate snack or fizzy drink is absolutely fine. It’s worth remembering one of the Foundation’s key messages – cut down on how often you have sugary foods and drinks. Oral health problems are caused by frequent consumption of these types of foods, so if children have these maybe once or twice a week during mealtimes and keep up a good oral hygiene routine, it will limit the damage their teeth will suffer.”

this problem is the education system.

“International School Meals Day is therefore a welcome and necessary initiative, seeking to bring experts and professionals from both sides of the Atlantic together to highlight the importance of good quality school meals, and sharing best practice on engaging children and their families in improving their eating habits. I am sure the day will go from strength to strength in the coming years.”

School meals should be a good thing and an opportunity to improve the wellbeing of children in the UK but they have to be healthy and nutritious.

This is what needs to happen if I’m to give my kids school meals, otherwise they’ll be on the pack ups, just as I was.

Sharon Hodgson, MP and Chair of the All Party Parliamentary Group (APPG) on School Food said: “Many countries face the serious and growing problem of childhood obesity and the further health issues this can cause. In all of those cases, the biggest asset at the disposal of Governments trying to tackle

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Oral health key to call to action Poor oral health has been linked to four of the five major killers – cancer, heart problems, strokes and respiratory problems – and investing in dentistry could potentially save millions of pounds treating these diseases, enabling the money to be ploughed back into the NHS. This has been emphasised after new research suggests almost £3,000 could be saved on treating heart disease and strokes if people were treated for gum disease4. Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, urges the public to take notice of these claims and reiterates the importance of looking after their mouths.

Dr Carter said: “The research sends a clear message that the risks caused by poor oral health should not be overlooked or considered less important when compared to others factors, particularly financial savings. Those figures give the clearest indication yet the cost of prevention far outweighs the costs involved with restorative and emergency care. You may think you are being financially prudent but reality is the cost of neglecting your oral health is even higher. That’s exactly what this study has found.

The British Dental Health Foundation is leading calls for the Health Secretary Jeremy Hunt to invest in dentistry to aid in his bid to tackle four of the five big killers in England.

The mortality call to action3 outlines Secretary Hunt’s ambition to save 30,000 avoidable deaths from the five major causes – cancer, heart, stroke respiratory and liver disease – and to make England among the best in Europe.

With these conditions currently killing more than 150,000 people under 75 every year, and with cardiovascular disease (CVD) representing about 30 per cent of all deaths in 2011, taking action on these five big killers will have a major impact in saving more lives.

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“Obesity, alcohol abuse, poor diet and smoking are generally well-known risk factors which can cause heart disease and strokes. Less well-known are the risks caused by gum disease, even though new causal links are being made with alarming frequency.

“The good news is that poor oral health is nearly always preventable and it is important that people make caring for their teeth a top priority. Regular visits to the dentist, as often as they recommend, is really important to give the dentist a chance to assess your oral health and, if necessary, give your teeth a scale and polish.

“This cannot be done in isolation. A simple routine of brushing teeth, twice a day for two minutes using a fluoride toothpaste, will help to remove plaque – the cause of gum disease. It is also important to clean in between teeth using interdental brushes or floss”, advised Dr Carter.

The results of the General Lifestyle Survey are encouraging for the nation’s health, according to a leading charity.

Lifestyle survey‘encouraging’, claims oral health charity The number of people smoking has more than halved in the last 37 years – 45 per cent in 1974 compared to just 20 per cent in 2011. The number of people smoking heavily fell between 1974 and 2011, from one in four (26 per cent) to only six per cent among men and from 13 per cent to four per cent among women.

Alcohol consumption amongst the general population followed the same trend. Both men and women are drinking less, yet the biggest drop was seen amongst 1624 year olds. Among men in this age group, the proportion drinking more than 4 units on their heaviest drinking day fell from almost half (46 per cent) in 2005 to a third (32 per cent) in 2011 and the proportion drinking more than 8 units decreased from almost a third (32 per cent) to less than a quarter (22 per cent) over the same period.

There have also been marked falls for women in this age group, with the proportion drinking more than three units on their heaviest drinking day falling from two in five (41 per cent) in 2005 to three in ten (31 per cent) in 2011 and the proportion drinking more than 6 units falling from more than one in four (27 per cent) to less than one in five (18 per cent).

Chief Executive of the British Dental Health Foundation, Dr

Nigel Carter OBE, praised awareness campaigns dedicated to highlighting the dangers tobacco use and alcohol pose as a fundamental factor behind a drop in usage.

Dr Carter said: “The impact of campaigns, such as Mouth Cancer Action Month, certainly contributes to people thinking twice about their lifestyle habits. It is encouraging to see these numbers falling, but I must stress there is a lot more we can do to help individuals who want to quit smoking and reduce their alcohol intake.

“Prevalence of mouth cancer in the UK is a growing concern. Tobacco use and drinking alcohol to excess are known risk factors, and together they increase the risk of developing the disease by up to 30 times.

“Other risks for the disease include poor diet and the Human Papillomavirus (HPV), and the Foundation’s message is simple – if in doubt, get checked out.”

Commissioned by the Office of National Statistics since 1971, the General Lifestyle Survey questioned 7,960 households in the UK. The survey collects data on a wide range of issues to paint a picture of the nation’s habits, including smoking, alcohol consumption, pensions, education and employment.

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Dental Industry Accolade for

Inventor Mum A mother unable to find a suitable toothbrush for her baby daughter has been highly commended in a National Dental Award for innovation.

Dominique Tillen of Brush-Baby Ltd based in Winchester, Hampshire, inspired the development, design and manufacture of a range of dental-care products for babies, toddlers and young children.

The magazine ‘Dental Hygiene & Therapy’ awarded Brush-Baby Product with the commendation praising the merits of Brush-Baby products for its innovation and catering for the niche market of infant dental health, a demographic previously not catered for.

Stocked by Leading High Street Retailers Major retailers including Boots are now stocking the products which have been featured on ITV 1 ‘Daybreak’, BBC ‘Breakfast’ and Dr Chris Steele’s Health Slot on ITV 1’s ‘This Morning’. The unique features of the products including DentalWipes, with Xylitol in its formulations and ergonomically-designed toothbrushes are ensuring

that the products are at the forefront of dental care for the next generation.

The dental award culminates a very successful year for the company with Brush-Baby achieving other prestigious business and product awards including the Nectar Small Business Award for ‘Innovation of the Year’ and Gold product awards from the parenting press.

40% of UK under 5s have tooth decay As Dominique explains; “There’s a misnomer that ‘baby teeth’ don’t matter, but this is not the case and parents and dentists now realise that it’s critical to look after both toothless gums and baby teeth. With decay rates in under-fives reaching 40% the Government is now setting targets for reducing decay and cavities in young children and our products are the ideal solution to this problem.”

“There’s a misnomer that ‘baby teeth’ don’t matter, but this is not the case and parents and dentists now realise that it’s critical to look after both toothless gums and baby teeth. “

The key to the success is hard work and belief. As Dominique continues: “How did I do it? I passionately believe in these products and want to ‘make a difference’.

I knew that education and distribution was the key so it has literally entailed ‘knocking on the doors’ of major retailers, explaining the need for infant dental-care products and the gap in the market as well as reaching out to mums and professionals alike.”

Interactive media, social networking and blogging have assisted in fuelling demand for the product range.

Mummy bloggers have raved about Brush-Baby’s Chewable Toothbrush and support includes some celebrity tweeters!

Dominique continues: “Dental-care essentially starts at home but many new parents are unsure what they need to do.

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Brush-Baby not only educates parents but it also has the products to help parents provide the best dental-care right from toothless gums through teething and onto brushing and flossing a full set of baby teeth. We get a tremendous reception at the Dental Shows with many dentists saying how pleased they are that at last they have products to recommend to parents.”

Recognition by the dental community and parenting press show that Brush-Baby is right on track providing dental-care of the under 5s up-to-date with major retailers such as Boots getting behind the products. Brush-Baby is set to become a ‘thought leader’ and generic name for infant and young children’s dental-care products. It just goes to prove the old adage that ‘mother really does know best!

Notes to editors: Brush-Baby provides innovative dental-care products for babies, toddlers and young children, supplying major retailers, dentists, pharmacies, specialist baby shops and distributors worldwide. For more information on Brush-Baby products and oral care advice visit www.brushbaby.co.uk.

For further information please contact: Marian Greally at Brush-Baby Ltd Tel: 0845 520 2229 Email: marian@brushbaby.co.uk

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Healthy Life, Healthy People:

Fluoride in Drinking Water Having practised on the border of Birmingham and Sandwell for much of my career I have seen, first hand, the positive impact water fluoridation can have on dental health. It still amazes me that it was possible to tell from which side of the dividing main road a child came from, simply by the state of their teeth.

However, the difference was remarkable.

Fluoride was added to the Birmingham supply in 1964 and the difference in dental health compared to the neighbouring population in non-fluoridated Sandwell was stark. At that time Sandwell was towards the bottom of the dental health leagues, however, when water fluoridation was introduced into the area in 1987 it transformed what was a poor performing borough amongst the top ten areas for dental health in the country.

Fluoride is a natural mineral that can be found in many foods. Practically all water supplies contain some fluoride and it was from noticing different patterns of dental decay in areas of naturally fluoridated water that the dental health benefits of fluoride were first observed.

Consequently, measures were taken in parts of the UK to add fluoride to drinking water.

Although water fluoridation schemes have been in place for more than 40 years, only around six million people in England receive water that has had its level of fluoride adjusted, and our knowledge

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of fluoride in general remains ordinary at best.

Many are apathetic about fluoride, some are not even aware if their water supply is fluoridated, while others continue to be unschooled as to what fluoride actually is.

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Fluoride is a naturally occurring mineral found in many foods and in all drinking water.

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Fluoride can greatly help dental health by strengthening the tooth enamel, making it more resistant to tooth decay.

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The addition of fluoride in toothpaste has been responsible for reducing decay by up to 50 %.

Our research indicates that more than one in four (28 per cent) think their water supply was fluoridated – greater than twice the true figure of one in ten (11 per cent) while more than 40 per cent admitted they had ‘no idea’ whether their water supply was fluoridated or not. And when we asked what fluoride is good for we received more worrying responses. One in eight (13 per cent) thought fluoride was a mint flavour; a similar number (12 per cent) said it was a tooth whitening product and around one in seven (15 per cent) purely thought it was a marketing gimmick.

Just over half (59 per cent) identified fluoride as an ingredient that helps to reduce decay.

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The use of fluoride in improving oral health is one that has been long documented and often prompts fierce debate between those who advocate its use and those who do not. For the first time, from April 1, Local Councils will gain the power to add or scrap fluoride in tap water, increasing the democratic legitimacy of decisions on fluoridation.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, talks about his experiences of water fluoridation, discusses the potential impact of the new ruling, along with the opportunities and potential dangers which the new scheme could have on our health.

And it is these disappointing figures, the education of fluoride and its benefits which we need to improve if we are to increase the number of areas in the UK that adopt additional levels into drinking water. If we can overcome this barrier then there is a realistic chance we can significantly improve levels of oral health.

LAs to act on a more urgent level than the previous regime. However, alongside this opportunity comes an exceptionally dangerous threat that could derail any progression we might hope to make.

Fluoride has always been a hotbed for generating activism.

And it has often been the case that those in opposition against fluoride have shouted louder than those who Successive governments since the mid-1980s have support it. They are a minority view, but activism, like any believed that decisions on fluoridation should be taken form of protest can quickly gather support and increase locally following public consultations. The feeling a mass following from latent publics. This audience will has been that local decision-makers (LAs) are best undoubtedly become the placed to take into account new battleground for those Research into fluoride locally-expressed views and to who wish to oppose fluoride, balance the perceived benefits for those who are not only Though there has been opposition, robust of fluoridation with the ethical looking for it not to be added scientific research supports the fact that arguments and any evidence of to any further areas in the UK, fluoride significantly improves oral health risks to health. And with new but who also wish for it to and there is no evidence to suggest that it can legislation coming in on April 1, be terminated from existing have any negative impact on overall health. public opinion on fluoride has fluoride schemes. never been so critical.

In the last few decades, there have been a If they become successful in The new Health and Social Care Act number of reports published on fluoridation causing unrest to acceptance 2012 will transfer responsibility for both in the UK and internationally. In of fluoride it would public consultation and decisionSeptember 2000, the University of York unquestionably be a severe hit making from SHAs to LAs. It published a report called ‘A Systematic for oral health in the UK. Those includes powers for the Secretary Review of Water Fluoridation’3 which who support the addition of of State for Health to make concluded that, in cases where the water had fluoride in drinking water, regulations on the consultations been fluoridated, 15 per cent more children such as us at the British Dental that LAs will be required to did not have tooth decay compared to those Health Foundation must speak undertake in ascertaining who were drinking unfluoridated water. It up, be more willing to engage public opinion on proposals for also showed that children in fluoridated areas in debate, teach and educate new fluoridation schemes or had, on average, 2.25 fewer teeth affected about fluoride. It is the single the variation or termination of by decay than children in non-fluoridated most important measure that existing fluoridation schemes. areas. This has been supported by a paper in we could take to improve oral the Journal of Dental Research, from March It is quite clear that publicallyhealth and if implemented 2013, which found that prolonged fluoride elected officials take in high on a substantial level it could exposure decrease decayed and filled teeth regard the views from those bring a considerable change by between 30 per cent and 21 per cent within their constituency. And to our dental wellbeing, it is because of this, that moving including solving current the decision-making powers to health inequalities which are LAs may turn out to be a blessing in disguise. Gathering rife in the UK, particularly in areas of social and economic wide scale public support for fluoride could persuade deprivation.

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