We understand that, in the British Fluoridation Society's (BFS) view, the prevalence of dental fluorosis of aesthetic concern in populations in the United Kingdom drinking artificially fluoridated water is lower than suggested by the York report. The BFS is independent of government, and the department has no influence on the content of its website. The information on the BFS's website differs from that provided in the York report in that it includes research studies completed after the report was published.
asked Her Majesty's Government:
Further to the Written Answers by Lord Darzi of Denham on 1 April (WA 155) and Lord Hunt of Kings Heath on 30 January 2001 (WA 55) in which they accepted the findings of the York systematic review of fluoridation, (a) whether the three studies on the British Fluoridation Society's website which were published after the York review are sufficient to overturn that review's estimate of a prevalence of fluorosis of aesthetic concern of 12.5 per cent; and (b) whether the other two studies on the website, published before the York review, were of sufficient quality to meet that review's inclusion criteria; and [HL3193]
Further to the Written Answer by Lord Darzi of Denham on 1 April (WA 155), whether the words of caution cited from the executive summary of the York review referred to the extent of fluorosis of aesthetic concern or to the number of people who would have to be exposed to water fluoridated at 1 part per million (ppm) as compared with 0.4 ppm for one additional person to develop fluorosis of aesthetic concern. [HL3194]
In the report Water Fluoridation and Health, published in 2002, the Medical Research Council (MRC) also suggested that the prevalence of aesthetically important dental fluorosis was probably lower than that reported in the York review. The MRC goes on to cite the three studies on the British Fluoridation Society's website which were published after the York review. Of the two studies on the website which pre-date the York review, one is cited in the review and the other is not. It is because of the conflicting research evidence that we have commissioned a new research project on the standardisation of the measurement of fluorosis using digital photography. If our research showed that concern about dental fluorosis was greater than we have assumed, one option would be to consider reducing the target concentration of one part per million currently used in artificial fluoridation schemes, but we would need to take into account any loss in the protective effect on teeth that a lower concentration would have.
asked Her Majesty's Government:
Further to the Written Answer by Lord Darzi of Denham on 1 April (WA 155), what steps they will take to ensure that the new research project therein referred to will take note of the comments in the executive summary of the York review by controlling adequately for the effects of potential confounding factors and observer bias. [HL3195]
The research is investigating whether photographic images can be automatically assessed by software to provide an objective assessment of the degree of fluorosis without the need for subjective assessments by examiners. This will enable true blinding of fluorosis studies to take place in accordance with recommendations of the York report.