The government is poised to reignite one of the most vexed medical issues of the past 50 years. Early next month, parliament will debate clauses of the water bill which will give indemnity against legal action to water companies that add fluoride to their supplies, paving the way for the extension of fluoridation schemes throughout this country.
Fluoridation is the addition of silicofluorides (hexafluorosilicic acid or, less commonly, sodium hexafluorosilicate) at the level of one part per million to public water supplies. The adversaries could not be more starkly opposed. Proponents believe that fluoridation brings about a reduction of caries in children's teeth, and that this is especially beneficial for children in socially deprived areas.
They insist that there are no detrimental public health consequences, whether short- or long-term. Opponents argue that silicofluorides are a class 2 poison under the Poisons Act, have serious adverse health effects, and in any case do nothing to benefit children's teeth.
Fluoridation schemes were first introduced in the United States in 1946. Since the late 1960s, about 10% of the UK population has received fluoridated water supplies - primarily, those in areas served by the Severn Trent, Northumbrian and Anglian water companies. During the postwar decades, the benefits of fluoride were held to be incontestable as dental health rapidly improved.
However, with better diet and treatment, it was improving across the western world. As far back as 1986, Nature published an article showing that rates of tooth decay were coming down as quickly in unfluoridated communities as in fluoridated ones.