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TOWARDS BETTER ORAL HEALTH IN CHILDREN: ANALYSIS OF CONSULTATION RESPONSES
CHAPTER 11: OTHER METHODS OF FLUORIDE DELIVERY
The consultation stated:
There has been much debate about the use of fluoride supplementation to prevent dental decay. One area of debate centres on the way in which fluoride is used. So, for example, freedom of choice is an issue if it is placed in the water supply but not if it is placed in milk where choice would be available. Milk, salt and water are vehicles by which dietary fluoride supplements can be delivered. Fluoride tablets and drops are further sources.
Consultees views were:
In Brief: Many respondents considered that delivering fluoride in ways other than in the water supply has advantages in preserving individual freedom of choice Milk, bottled water and fizzy drinks were seen as suitable candidates for fluoridation More active promotion of fluoridated dental products was advocated by some
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In Detail:
General themes to emerge were that there were already fluoridated products available for use, and that extending fluoridation to other products enhanced opportunities for better oral health whilst preserving the individual's choice of whether to expose themselves to fluoride.
Many commented on the ready availability of fluoride toothpastes, with several calling for the removal of VAT from both toothbrushes and fluoride paste. Fluoride tablets were also perceived as readily accessible and free on prescription.
For several respondents, milk was seen as an appropriate drink to which fluoride could be added. Such milk should be especially labelled (indiv 174). It was of note that Borders NHS Board registered interest in becoming a pilot area for the introduction of fluoridated milk for children.
The Borders and other rural areas outlined the practical problems associated with water fluoridation in their areas and clearly saw fluoridation of other products as one way to address their difficulties - e.g. in remoter rural areas where fluoridation of the water supply is impractical, bottled fluoridated water could be considered (Community Dental Department, Western Isles). The fluoridation of bottled water was suggested by several respondents (e.g. S. Aryshire Council).
A common recommendation for ensuring fluoride reached its target efficiently was for fizzy drinks to be fluoridated. Several respondents named Coca-Cola and/or Irn Bru as suitable candidates (Torryburn-Newmills Community Council, indiv 1228). A few suggested extending this targeted approach to certain junk food, or healthy products - fruit juices, even cereals (NHS Argyll and Bute, NHS Forth Valley Board). Salt could also be fluoridated (e.g. GP 143, Argyll and Bute Council) although some cautioned against presenting mixed messages to children regarding the healthy benefits and appropriate levels of salt intake.
Some people acknowledged that fluoridated dental products were already available but could be more actively promoted. Amongst those mentioned were mouthwashes, dentifrice, fluoride varnish, and slow releasing fluoride beads (e.g. Amicus, indiv 225, Fife Council Children and Adult Services (suggested a large-scale trial), Professor of Paediatric Dentistry, University of Glasgow). Fluoridated gum was also advocated (indiv 470, GP 18 -"
less boring for children").
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