30 Jan 2009
29 Jan 2009
Ireland - New guidelines issued for topical fluorides
New guidelines issued for topical fluorides 28th January 2009
New guidelines on the use of topical fluorides for the prevention of tooth decay in Irish children and adolescents are now available.
The aim of the guidelines is to maximise the benefits from the use of topical fluorides for Irish children under the age of 16 years. The guidelines cover fluoride-containing toothpastes and mouthrinses, as well as professionally applied fluorides, including varnishes and gels.
The guidelines were developed in response to a consultancy report on the use of fluorides in the promotion of oral health in the Republic of Ireland, and their launch marks the introduction of the first evidence-based principles for the HSE public dental service.
Lead researcher Carmel Parnell, a senior HSE dental surgeon, said that the report found variations across the country in the practices and policies for caries-prevention programmes involving fluorides, and identified a lack of guidance within the public dental service on the best use of professionally applied topical fluorides.
Although the guidelines were put together for the public dental service, Ms Parnell points out that they will also be of interest to general dental practitioners and their dental teams, and to parents of children using the public service.
The guidelines will be implemented this year, but according to Ms Parnell it will be probably a number of years before their impact will be seen.
The guidelines were established by a collaborative group involving the Oral Health Services Research Centre in UCC, the HSE and the Cochrane Centre in Oxford. The initiative was funded by a strategic research and development award from the Health Research Board.
21 Jan 2009
Those responsible for introducing fluoridation if the scheme goes ahead.
It is obvious from the monetary, practical and moral support we have received from the public and the letters published in the Echo that overwhelmingly, Southampton does not want fluoridation. If the decision is made to implement fluoridation then only one group of people is responsible - the Southern Central SHA Board.A record of the way they vote should be kept so that if in the future circumstances prove that the objections raised against fluoridation are valid whether locally or internationally then these are the people who are responsible for any harm done.The Board: NHS South Central, Rivergate House, Newbury Business Park, Newbury, RG14 2PZ
Dr Geoffrey Harris - Chairman
Jim Easton - Chief Executive
Chris Evennett - Director of Strategy and Reform
Katherine Fenton - Director of Clinical Standards
Olga Senior - Director of Communications & Corporate Affairs
Ben Lloyd - Director of Finance and Investment
Prof. John Newton Regional Director of Public Health
Terry Butler CBE
Alyson Coates.
Joe McLoone
Chris Le Fevre
Martin Howell
Who else is responsible for the never ending push for fluoridation in recent years? Number one is:
Andy Burnham, Leigh's Labour MP filed an early day motion calling for the fluoridation of water. He said "My message is blunt: it is time to stop a vocal, letter-writing minority standing in the way of a progressive change that will benefit millions of people in Britain, especially in our most deprived communities." "I suggest that the tiny minority of the population who do care are well off enough to afford Evian."
Mr. John Denham MP for Southampton who at the time was the Minister of State, Department of Health said in a speech in Parliament "The evidence shows that fluoridation of the water supply to the optimum level of one part per million can reduce the amount of tooth decay in children from similar backgrounds by one third to a half" "There is currently evidence of just one minor, cosmetic side effect of fluoridation--dental fluorosis, or slight tooth mottling. Where water is fluoridated at the optimal level of one part per million and parents follow the instructions on fluoridated toothpaste to ensure that children do not swallow excessive amounts, that is seldom noticeable. The teeth are still endowed with extra resistance. If someone is concerned about the cosmetic effect, dentists have several remedies. Often a satisfactory outcome can be achieved by the dentist who polishes the teeth"
Alan Whitehead MP blindly follows the government line "Be assured that government policy on the matter will follow only what the most up-to-date scientific research indicates is permissible".
Dr Geoffrey Harris - Chairman
Jim Easton - Chief Executive
Chris Evennett - Director of Strategy and Reform
Katherine Fenton - Director of Clinical Standards
Olga Senior - Director of Communications & Corporate Affairs
Ben Lloyd - Director of Finance and Investment
Prof. John Newton Regional Director of Public Health
Terry Butler CBE
Alyson Coates.
Joe McLoone
Chris Le Fevre
Martin Howell
Who else is responsible for the never ending push for fluoridation in recent years? Number one is:
Andy Burnham, Leigh's Labour MP filed an early day motion calling for the fluoridation of water. He said "My message is blunt: it is time to stop a vocal, letter-writing minority standing in the way of a progressive change that will benefit millions of people in Britain, especially in our most deprived communities." "I suggest that the tiny minority of the population who do care are well off enough to afford Evian."
Mr. John Denham MP for Southampton who at the time was the Minister of State, Department of Health said in a speech in Parliament "The evidence shows that fluoridation of the water supply to the optimum level of one part per million can reduce the amount of tooth decay in children from similar backgrounds by one third to a half" "There is currently evidence of just one minor, cosmetic side effect of fluoridation--dental fluorosis, or slight tooth mottling. Where water is fluoridated at the optimal level of one part per million and parents follow the instructions on fluoridated toothpaste to ensure that children do not swallow excessive amounts, that is seldom noticeable. The teeth are still endowed with extra resistance. If someone is concerned about the cosmetic effect, dentists have several remedies. Often a satisfactory outcome can be achieved by the dentist who polishes the teeth"
Alan Whitehead MP blindly follows the government line "Be assured that government policy on the matter will follow only what the most up-to-date scientific research indicates is permissible".
20 Jan 2009
PUBLIC MEETING
PUBLIC MEETING ON
WATER FLUORIDATION
Speaker: Dr Peter Mansfield
Dr Mansfield has researched the effects of water fluoridation on health for many years. He was a member of the research review group for the York Review on water fluoridation. If you would like to learn more about the issues concerning fluoridation of drinking water, come to this public meeting where you can listen to one of the UK's leading authorities on fluoridation, ask questions, pick up leaflets and talk to local campaigners. The public meeting will be followed by Hampshire Against Fluoridation's Annual General Meeting.
All Welcome Free of Charge
Date: Saturday 31st January 2009
Time: 2pm - 4pm
Place: Friends Meeting House
1a, Ordnance Road
Southampton SO15 2AZ
For more information contact Hampshire Against Fluoridation
Tel: 02380 493776 or 02392 463761
WATER FLUORIDATION
Speaker: Dr Peter Mansfield
Dr Mansfield has researched the effects of water fluoridation on health for many years. He was a member of the research review group for the York Review on water fluoridation. If you would like to learn more about the issues concerning fluoridation of drinking water, come to this public meeting where you can listen to one of the UK's leading authorities on fluoridation, ask questions, pick up leaflets and talk to local campaigners. The public meeting will be followed by Hampshire Against Fluoridation's Annual General Meeting.
All Welcome Free of Charge
Date: Saturday 31st January 2009
Time: 2pm - 4pm
Place: Friends Meeting House
1a, Ordnance Road
Southampton SO15 2AZ
For more information contact Hampshire Against Fluoridation
Tel: 02380 493776 or 02392 463761
15 Jan 2009
NHS South Central blazes a trail on water fluoridation
NHS South Central blazes a trail on water fluoridation
Published: 15 January 2009 01:00 Author: Rebecca Evans More by this Author Last Updated: 14 January 2009 16:14 Reader Responses
The consultation over putting fluoride in water supplies on the south coast is proving a 'totemic argument between state and individual'. Other areas will be watching the outcome closely, reports Rebecca Evans
Next month, the board of NHS South Central will decide whether to fluoridate the water in parts of Southampton and south west Hampshire.
The decision will be significant, not just for the 195,000 people it will affect directly, but because the whole process of consultation, decision making and any subsequent fallout is being watched keenly by other strategic health authorities and primary care trusts that might want to follow suit.
Fluoridation is a contentious issue. NHS South Central is the first region to consult on water fluoridation since the legislation changed in 2005.
"This is public health in the raw, being debated and discussed in local communities. It's what we are on the pitch to do"
At that point, the government made it clear that it supported fluoridation to improve dental health where the local population was consulted and left the decision up to strategic health authorities.
Only a small minority of people in the UK - around five million - live in places with artificially fluoridated water, mostly in the West Midlands and Tyneside. Many of these areas have drunk fluoridated water for decades.
Passionate views
But introducing it in a new area is a different matter, bringing forth passionate and strongly held views for and against. These are not just about the dental health benefits or cost-efficiency, but also debates over public health interventions versus personal choice or, as NHS South Central chief executive Jim Easton puts it, "a totemic argument between the state and the individual".
Unsurprisingly, this makes the consultation difficult and fraught. It also makes the process extremely important.
As the first region to attempt to introduce fluoridation since the law changed, it must be fair, transparent and follow the rules to the letter, and be seen to be. If the SHA does decide to introduce fluoridation, neither it, nor the government, would want to see it face a judicial review.
Chief dental officer for England Barry Cockcroft says: "It's very important with this first one that it's properly done; in many ways it tests the legislation that we have got it right."
Consultation
The SHA has put a lot of effort into ensuring it hears everyone's opinion (see box, below). The issue attracts national and even international lobbying groups. These should have their say, Mr Easton says, but must be balanced with the often "quieter voices" of local groups.
There is also the question of how to tackle what he calls "the battle for truth in an information age" - that is, people forming views based on information they have largely found on the internet.
Mr Cockcroft, one of the pro-fluoridation panellists at all three of South Central's Question Time-style public debates (see box below), says this is what he found most challenging. "The most difficult arguments to cope with are the ones that sound like they are scientific but are not, but people who are not scientifically based themselves are very easily influenced by that kind of thing."
Mr Cockcroft says it is for these kinds of reasons that the legislation says the SHA must assess the cogency of the competing arguments. To enable it to do this, it went out to tender for an independent scientific adviser who will weigh up the evidence and advise the board.
Southampton City PCT is free to openly commend the proposal to fluoridate the water. It is the PCT that requested the consultation based on its concern that dental health in the area is among the worst in the country and its belief that raising the level of fluoride in the water supply would significantly improve the dental health of local people, particularly children.
Nothing to smile about
PCT director of public health Andrew Mortimore says the PCT reviewed the area's oral health needs and found that dental health had not improved in five years - in fact, the figures were worse in 2006 than they had been in 2002. More than four in 10 children had tooth decay by the time they started school.
Dr Mortimore says the problem tends to be worst in areas with the greatest social disadvantage.
"We spent a lot of time, a lot of money on schemes, got a lot of very good people working on oral health promotion, dietary improvements, dental hygiene, supporting parents and families, but at the end of the day it was not making the difference. We came to the conclusion we needed to re-look at water fluoridation and whether it could be introduced."
He compares Southampton's situation enviously with the West Midlands, where the water has been fluoridated for around 40 years and with the best dental health in the country - certainly much better than the socioeconomic demographics would suggest.
"We understand that this is an issue where you cannot get a yes from everyone and choice is an important issue, but so is the choice to have fluoridated water. It is the most vulnerable in our communities who can't make the decision for themselves, particularly the children."
SHA vs PCT
Southampton city council has come out in favour of the fluoridation proposals - but Hampshire county council, which covers some smaller areas that would also be affected, is against. Anna McNair Scott, chair of the council's health overview and scrutiny committee, says fluoridation seems to her to address a symptom of health inequalities - poor dental health - rather than its causes, such as bad diet, which will still lead to other health problems and inequalities.
What the general public will make of the proposal remains to be seen. Dr Mortimore says the opinion survey conducted before the consultation began would suggest there is a good measure of public support. "I don't think there's anything else that public consultation on a health issue is quite like this in terms of the firm views and passion it attracts in those who are opposed to something that the NHS is consulting on that is for the benefit of a population."
It is also difficult to convey to the lay person that the PCT and the SHA have different roles, he says. The PCT is the key proponent, while the SHA is the decision maker and the organisation responsible for the consultation. "We can't be seen to be joined up in ways that feel very different from most other things we do as an NHS," he says.
The PCT's responsibility for tackling health inequalities does not, on this issue, always resonate with the public. At the debate, several members of the public argue that fluoridation should not be imposed on everyone to improve the dental health of a feckless minority.
Individualism
The suggestion by the independent chair of the panel, Radio 4 broadcaster Peter White, that part of the objective of a public health system is "to reach people who cannot be reached by other methods" seems, among that particular audience at least, to fall on deaf ears.
NHS South Central deputy director of public health James Mapstone believes views on the greater good have changed.
"What [the drop-in events] made clear to me is how much individual choice is really precious to some people now and I do think that's probably a shift from where we were 20 years ago, even 10 years ago.
"They used to take more of a 'I will do this for society as a whole' [position] and I'm starting to feel that there's a change and public health has to respond to that."
But Mr Easton says he is "really pleased about the level of discussion and debate, even though some of it is vigorous and difficult".
"This is public health in the raw, being debated and discussed in local communities. It's what we are on the pitch to do."
The SHA board will make its decision, in public, on 26 February.
Published: 15 January 2009 01:00 Author: Rebecca Evans More by this Author Last Updated: 14 January 2009 16:14 Reader Responses
The consultation over putting fluoride in water supplies on the south coast is proving a 'totemic argument between state and individual'. Other areas will be watching the outcome closely, reports Rebecca Evans
Next month, the board of NHS South Central will decide whether to fluoridate the water in parts of Southampton and south west Hampshire.
The decision will be significant, not just for the 195,000 people it will affect directly, but because the whole process of consultation, decision making and any subsequent fallout is being watched keenly by other strategic health authorities and primary care trusts that might want to follow suit.
Fluoridation is a contentious issue. NHS South Central is the first region to consult on water fluoridation since the legislation changed in 2005.
"This is public health in the raw, being debated and discussed in local communities. It's what we are on the pitch to do"
At that point, the government made it clear that it supported fluoridation to improve dental health where the local population was consulted and left the decision up to strategic health authorities.
Only a small minority of people in the UK - around five million - live in places with artificially fluoridated water, mostly in the West Midlands and Tyneside. Many of these areas have drunk fluoridated water for decades.
Passionate views
But introducing it in a new area is a different matter, bringing forth passionate and strongly held views for and against. These are not just about the dental health benefits or cost-efficiency, but also debates over public health interventions versus personal choice or, as NHS South Central chief executive Jim Easton puts it, "a totemic argument between the state and the individual".
Unsurprisingly, this makes the consultation difficult and fraught. It also makes the process extremely important.
As the first region to attempt to introduce fluoridation since the law changed, it must be fair, transparent and follow the rules to the letter, and be seen to be. If the SHA does decide to introduce fluoridation, neither it, nor the government, would want to see it face a judicial review.
Chief dental officer for England Barry Cockcroft says: "It's very important with this first one that it's properly done; in many ways it tests the legislation that we have got it right."
Consultation
The SHA has put a lot of effort into ensuring it hears everyone's opinion (see box, below). The issue attracts national and even international lobbying groups. These should have their say, Mr Easton says, but must be balanced with the often "quieter voices" of local groups.
There is also the question of how to tackle what he calls "the battle for truth in an information age" - that is, people forming views based on information they have largely found on the internet.
Mr Cockcroft, one of the pro-fluoridation panellists at all three of South Central's Question Time-style public debates (see box below), says this is what he found most challenging. "The most difficult arguments to cope with are the ones that sound like they are scientific but are not, but people who are not scientifically based themselves are very easily influenced by that kind of thing."
Mr Cockcroft says it is for these kinds of reasons that the legislation says the SHA must assess the cogency of the competing arguments. To enable it to do this, it went out to tender for an independent scientific adviser who will weigh up the evidence and advise the board.
Southampton City PCT is free to openly commend the proposal to fluoridate the water. It is the PCT that requested the consultation based on its concern that dental health in the area is among the worst in the country and its belief that raising the level of fluoride in the water supply would significantly improve the dental health of local people, particularly children.
Nothing to smile about
PCT director of public health Andrew Mortimore says the PCT reviewed the area's oral health needs and found that dental health had not improved in five years - in fact, the figures were worse in 2006 than they had been in 2002. More than four in 10 children had tooth decay by the time they started school.
Dr Mortimore says the problem tends to be worst in areas with the greatest social disadvantage.
"We spent a lot of time, a lot of money on schemes, got a lot of very good people working on oral health promotion, dietary improvements, dental hygiene, supporting parents and families, but at the end of the day it was not making the difference. We came to the conclusion we needed to re-look at water fluoridation and whether it could be introduced."
He compares Southampton's situation enviously with the West Midlands, where the water has been fluoridated for around 40 years and with the best dental health in the country - certainly much better than the socioeconomic demographics would suggest.
"We understand that this is an issue where you cannot get a yes from everyone and choice is an important issue, but so is the choice to have fluoridated water. It is the most vulnerable in our communities who can't make the decision for themselves, particularly the children."
SHA vs PCT
Southampton city council has come out in favour of the fluoridation proposals - but Hampshire county council, which covers some smaller areas that would also be affected, is against. Anna McNair Scott, chair of the council's health overview and scrutiny committee, says fluoridation seems to her to address a symptom of health inequalities - poor dental health - rather than its causes, such as bad diet, which will still lead to other health problems and inequalities.
What the general public will make of the proposal remains to be seen. Dr Mortimore says the opinion survey conducted before the consultation began would suggest there is a good measure of public support. "I don't think there's anything else that public consultation on a health issue is quite like this in terms of the firm views and passion it attracts in those who are opposed to something that the NHS is consulting on that is for the benefit of a population."
It is also difficult to convey to the lay person that the PCT and the SHA have different roles, he says. The PCT is the key proponent, while the SHA is the decision maker and the organisation responsible for the consultation. "We can't be seen to be joined up in ways that feel very different from most other things we do as an NHS," he says.
The PCT's responsibility for tackling health inequalities does not, on this issue, always resonate with the public. At the debate, several members of the public argue that fluoridation should not be imposed on everyone to improve the dental health of a feckless minority.
Individualism
The suggestion by the independent chair of the panel, Radio 4 broadcaster Peter White, that part of the objective of a public health system is "to reach people who cannot be reached by other methods" seems, among that particular audience at least, to fall on deaf ears.
NHS South Central deputy director of public health James Mapstone believes views on the greater good have changed.
"What [the drop-in events] made clear to me is how much individual choice is really precious to some people now and I do think that's probably a shift from where we were 20 years ago, even 10 years ago.
"They used to take more of a 'I will do this for society as a whole' [position] and I'm starting to feel that there's a change and public health has to respond to that."
But Mr Easton says he is "really pleased about the level of discussion and debate, even though some of it is vigorous and difficult".
"This is public health in the raw, being debated and discussed in local communities. It's what we are on the pitch to do."
The SHA board will make its decision, in public, on 26 February.
11 Jan 2009
Fluoride flaws
Fluoride flaws SIR – As you report (January 2), ministers are awaiting the results of a public consultation by South Central Strategic Health Authority (SHA), which is considering adding fluoride to the drinking water in Southampton and south-west Hampshire. The problem with the SHA document is that its authors have their minds made up. Pros and cons are supposedly set out on pages 15 to 23. The first page and a half sets out benefits without challenge. The next seven pages set out the objections – only to rebut them in each and every case. The prize for partiality must go to Southampton City Primary Care Trust, which has evidently spent shedloads of public money producing and distributing one-sided propaganda. My favourite is the glossy postcard (with pre-paid first-class postage) for people to sign and send off to the SHA – despite the fact that the SHA says it will not be relying solely on the number of responses received. We all know a flawed consultation when we see one. The Cabinet Office code of practice on consultations requires that “responses should be carefully and open-mindedly analysed”. Clearly this is not happening. As a local MP, I have formulated a detailed submission to the SHA. This is for the benefit of the people I represent, not the SHA – which I expect to ignore it. Julian Lewis MP (Con)London SW1
2 Jan 2009
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