Hereford, Texas, could provide solution to county’s child tooth decay problem

Herefordshire may have one of the worst records for tooth decay among five-year-olds across the West Midlands but health bosses could learn a trick or two from Hereford’s American namesake.

The Texan city of Hereford is known as the ‘town without a toothache’, health officials there believe this is due to high levels of naturally occurring fluoride levels in the water.

Drinking water fluoridation is a highly divisive issue and continues to attract vocal opposition from some groups.

Herefordshire is not currently part of a fluoridation scheme but a recent report by Public Health England found that five-year-olds in areas with it were much less likely to experience tooth decay.

Lara Anton, press officer at Texas Department of State Health Services, explained local jurisdictions in the state decide whether or not to fluoridate their water.

Hereford in Deaf Smith County has a natural fluoride level in its water supply of 2.6 mg per litre. The optimal amount of fluoride in drinking water should be 0.7 mg per litre, according to Centers for Disease Control and Prevention, the leading national public health institute of the United States.

“When fluoride levels are this high, fluorosis begins to form on children’s teeth when they are developing. People with fluorosis on their teeth are more resistant to tooth decay,” Ms Anton said.

Nuala Woodman, deputy head of commissioning at NHS England West Midlands, said that approximately a quarter of five-year-olds have tooth decay in Herefordshire with on average three or four teeth affected.

She presented a children’s dental health report as part of the Herefordshire Spotlight Review to children and young people scrutiny committee last week.

Ms Woodman said the majority of tooth decay in children under six is untreated and less than 12% of children attend a dentist before their second birthday.

Karen Wright, Director of Public Health for Herefordshire, said she was concerned that the number of five-year-olds in the county with at least one decayed, missing or filled tooth is higher than the national average.

“I have pledged to work with the county’s health and wellbeing board, and other partners, to develop a comprehensive oral health plan to tackle poor oral health in the county’s children,” she said.

“There are a wide range of interventions that can be put in place to improve oral health and we will soon be starting an oral health needs assessment which will help to identify the range of options that would best suit Herefordshire, this would include looking at fluoridating the mains water supply.

“We would also urge parents and carers to ensure their children brush their teeth twice a day, that they regularly see a dental professional and to reduce the amount of sugary foods and drinks their child consumes throughout the day.”

Early dental attendance has not traditionally been encouraged in Herefordshire and many children do not visit a dental practice until dental disease is well established, or they are in pain and require admission to hospital.