The board of South Central strategic health authority has decided to add fluoride to the water supply in Southampton.

Members of the board made the unanimous decision at a public meeting yesterday, following a consultation on the proposal.

It will now instruct Southern Water to increase the level of fluoride in the local water supply from 0.08 parts per million to 1ppm, which it says is the optimal level for tackling tooth decay.

A statement from the SHA said its board was satisfied that water fluoridation at 1ppm was a safe and effective way to tackle tooth decay in Southampton and that the health benefits outweighed all other arguments against the proposal.

South Central SHA will write to Southern Water to instruct them to add fluoride to the water and will work with the water authority to implement the scheme. Fluoridation is not expected to take place before 2010.

Weighing up the evidence

Following the consultation, board members considered an independent report analysing more than 10,200 responses and the results of a phone survey of more than 2,000 people.

The board also received presentations from Southampton City primary care trust, which had requested the move, and Hampshire Against Fluoridation, the local anti-fluoridation campaign group. South Central director of public health Professor John Newton gave his professional view of the scientific evidence.

Contentious issue

South Central SHA chief executive Jim Easton said: “We recognise that water fluoridation is a contentious issue for some people, but we have welcomed the opportunity that this public consultation has given us to debate this important public health issue fully with the people of Southampton and south west Hampshire.

“The board was satisfied that, based on existing research, water fluoridation is a safe and effective way to improve dental health. It is something which has been added to the water supply in parts of the UK including Birmingham for many years, and despite the best public health monitoring available no significant health problems have been identified.

Opposition

“Written responses to the consultation indicated opposition to the proposal but it was clear from the results of the independent phone poll which highlights the opinions of a representative cross section of local people that, despite some groups claiming to represent the majority view, there is no clear majority of opinion amongst the public in the local area.”

Mr Easton continued: “During the consultation, the SHA received responses from all of the local authorities across the local area. The responses showed a split in opinion between elected members in Southampton City and those representing the parts of south west Hampshire covered by this proposal. The board gave full regard to the views of each council and local MPs. The board acknowledged the fact that the majority of people covered by this proposal lived within Southampton City where the council supports the proposal.”

Professor Newton said: “As the regional director of public health, charged with protecting and improving the health of everyone in the South Central region, I am pleased with the board decision.

Benefits to society

“This consultation highlights the role of the NHS in addressing public health issues - it sometimes has to balance individual rights against the benefits to society as a whole. These are complex issues and I have no doubt that this debate will continue but for future generations of children in Southampton and parts of south west Hampshire they will benefit from this decision through improved dental health.

“The consultation also highlights the challenge of discussing public health issues in the age of the internet where people need to try and evaluate the mass of information available on water fluoridation, some of which is unreliable and inaccurate. The results of the phone survey showed that a quarter of those people who opposed water fluoridation did so because of a fear that it would damage their health. Some of the support for the proposal is likely to have been eroded by misinformation.

“As an epidemiologist, I am convinced by the available evidence and by the experience of water fluoridation across the world over 60 years that there is no basis for these concerns.

“Local people should be reassured that every major professional medical organisation including the British Dental Association, British Medical Association and World Health Organisation all fully endorse water fluoridation as a safe and effective way to improve dental health.

“The SHA will monitor the water fluoridation scheme when it is put in place.”