Question to the Department of Health and Social Care:

To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 17 November 2015 (HL3315), why the Executive Summary of the report by Public Health England <i>Water fluoridation: Health monitoring report for England 2014</i> concludes that "The report provides further reassurance that water fluoridation is a safe and effective public health measure", when the Limitations section of the report states that "there was potential for considerable misclassification of exposure status" and the Conclusion section states that "the population-based, observational design does not allow conclusions to be drawn regarding any causative or protective role of fluoride".

The Public Health England report, Water Fluoridation: Health Monitoring Report for England 2014 was, of necessity, an ecological study. An ecological design is appropriate for monitoring health outcomes in fluoridated and non-fluoridated populations. All academic research has limitations. In designing and conducting research consideration must be taken regarding timescales for publication and cost to the public purse. Stating the limitations of the study within the body of a paper is considered good scientific practice.

The report discusses the limitations of this study design, including the potential for mis-classification of fluoride exposure status, using an ecological level of measurement with regard to water fluoridation rather than individual fluoride intake. The report’s findings, however, concur with those of numerous authoritative reviews of water fluoridation that finds levels of tooth decay are lower in fluoridated areas and that there is no convincing evidence that water fluoridation causes adverse health effects.

For these reasons the author’s conclusion "The report provides further reassurance that water fluoridation is a safe and effective public health measure" is appropriate.

With over 70 years’ experience of water fluoridation internationally and over 50 years’ experience in the United Kingdom, there has been no convincing scientific evidence to indicate that water fluoridation has caused harm to health.