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Despite major improvements in oral health during the last 30 years, there remains a strong association between oral health and social disadvantage. The 2003 National Survey of Child Dental Health showed that the probability of five-year old children having decayed primary teeth was about 50 per cent. higher in the poorest social groups than the wealthiest group. Among 15-year-olds from managerial and professional backgrounds, 47 per cent. had obvious decay experience compared with 65 per cent. from routine and manual socio-economic backgrounds.
The fluoridation of water offers the best prospect of reducing these inequalities. The Water Act 2003 gives strategic health authorities (SHAs) the power to instruct water companies to fluoridate supplies. Last autumn, South Central strategic health authority consulted the public on fluoridating Southampton and parts of south west Hampshire and, on 26 February, decided to proceed with fluoridation. A number of other SHAs are now actively considering the possibility of new water fluoridation schemes.
Recognising that it may not be feasible to fluoridate all high need areas, the Government have developed the ‘Brushing for Life' programme. ‘Brushing for Life' involves health visitors giving families with young children in high need areas advice on preventing dental decay, and a free pack containing a tube of fluoridated toothpaste, a toothbrush and a leaflet on oral hygiene. In many areas, the programme is delivered in Sure Start Children's Centres. Some 18,000 packs were issued in 2008.
In December, the Department asked Professor Jimmy Steele to lead an independent review of national health service dentistry and his remit includes looking at current contractual arrangements, as well as specific issues raised in last summer's Health Select Committee report on dental services. Professor Steele is engaging widely with the public, the dental professions and the NHS, including on attitudes towards the dental contract. He is due to report his findings in the summer.