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Impact of water fluoridation on dental health inequalities in the West Midlands

In 2006, an analysis of tooth decay rates across the West Midlands published in a report by the regional director of public health showed that (1)

  • Children in fluoridated areas with relatively high levels of social deprivation often had better dental health than children in relatively affluent areas where water supplies are not fluoridated.

  • In fluoridated areas there was a smaller difference in tooth decay rates between children in the most affluent and most socially deprived families than there was between children from these different social groups in non-fluoridated areas.

From the 2010 health profiles of English regions and areas produced by the Association of Public Health Observatories (APHO) it is possible to compare the West Midlands with the rest of the country in terms of relative deprivation and children’s dental health (2).

The West Midlands is one of the most deprived regions in the country.  Nearly five times more people in the West Midlands than the South East (27.4% compared with 5.9%) are among the most deprived fifth of the population of England.  Levels of deprivation across the West Midlands are significantly worse than the national average.

Despite its relatively high social deprivation, the West Midlands has significantly better children’s dental health than other regions with comparable deprivation.  On average, 5-year olds in the North West region and Yorkshire and The Humber region have 50% more tooth decay than those in the West Midlands, whilst 5-year olds in London have 30% more tooth decay than those in the West Midlands.

The West Midlands has the most extensively fluoridated water supplies of any region in the country.  Around 70% of its residents receive fluoridated tap water in their own homes, compared with just 4% in the North West and less than 3% in Yorkshire and The Humber.

Five-year olds in the West Midlands have the same level of dental health overall as children from the entirely non-fluoridated South West, although around three times more people from the West Midlands are among the most deprived fifth of the England population.  This is further evidence of the benefits of water fluoridation in reducing the effects of deprivation.

1. Choosing Health for the West Midlands: A Report of the Regional Director of Public Health, Government Office for the West Midlands, 2006.

2.  Association of Public Health Observatories and Department of Health (2010): Health Profile 2010 – West Midlands.