Making Decisions on Fluoridation

The format of this page is

• A summary of the key points relevant up to 2020
• An online and printable version of the 2012/3 publication “one in a million”
• A summary of the main points raised by more recent papers and reports
• Access to a list of the key papers and reports published since 2012/3
• Access to an archive of other reports etc.

• Decisions about whether to introduce a water fluoridation scheme to reduce tooth decay have always been made at a local level in the UK either by local authorities or by health authorities.
• From 2013, the decision-making responsibility has rested with local authorities, as it did before 1974. Between 1974 and 2003, it rested with area and district health authorities, and between 2003 and 2013 with strategic health authorities.
• Legislation requires a full public consultation lasting at least three months to be undertaken before a final decision about whether or not to fluoridate water supplies is made.
• Water companies are required by law to accede to requests made by the ‘relevant authority’ to fluoridate specified water supplies.
• Public Health England has published a detailed and helpful toolkit in 2016.

• Public Health England have published a detailed toolkit outlining the relevant primary and secondary legislation concerning community water fluoridation. The document lays out a step by step guide for local authorities wishing to commission new schemes.
• The UK Government is taking legislation through Parliament (2022) to expedite implementation of water fluoridation. This move reflects a recent paper (Lowery, Flinders and Gibson, B. (2021) When evidence alone is not enough: the problem, policy and politics of water fluoridation in England) which postulates that political issues need to be resolved if further implementation is to go ahead.