Sir Sadiq Khan has been urged to hold a review into whether the capital’s water supply should be fluoridated to reduce tooth decay among Londoners.
Following a cross-party investigation, the London Assembly’s health committee has, among other recommendations, told the mayor the move could play a valuable part in improving oral health across the capital.
Sir Sadiq’s team said he was “concerned about the challenges many Londoners face accessing dental services” and would respond to the committee “in due course”.
The recommendation about potentially fluoridating London’s water was issued after the committee was told by NHS consultant Charlotte Klass that fluoridation successfully reduces the prevalence of tooth decay “in all sectors of society, irrelevant of age, and most importantly it does not require a sustained behavioural change at an individual level”.
Water is not routinely fluoridated in London, but since 2022, the Health Secretary has had the power to introduce water fluoridation schemes in different parts of the country.
Public consultation is needed before using that power. In 2024, the Government consulted on expanding water fluoridation schemes in the north east of England, but has announced no such plans for London.
The committee said the mayor “should carry out a review of the feasibility of fluoridating London’s water in 2025” and “should submit the findings of this review to the Government”.
In their investigation, the committee found that some 25.8 per cent of five-year-olds in the capital experienced tooth decay in 2021-22 – slightly higher than the English average of 23.7 per cent. In the year that followed, more than 5,000 children aged 0 to 9 in London were admitted to hospital for tooth extractions.
Looking at the two years to March 2024, just 39 per cent of the capital’s adults accessed an NHS dentist.
The report states: “The current NHS dental contract is severely flawed and needs fundamental reform.
“As well as disincentivising dental professionals from taking on NHS work, the evidence received by the committee suggests that the contract disincentivises them from targeting work towards those with the highest needs and is not designed to focus on prevention.
“Funding for NHS dentistry has not kept pace with inflation. There is currently not sufficient commissioned NHS activity to meet the needs of London’s population.”
The committee’s Labour chair, Krupesh Hirani, said: “We examined the current state of dental education in schools, as well as the challenges faced by Londoners in accessing NHS dental services and receiving quality care.
“We found much that was successful, but the gaps in preventative work and emergency treatment are significant and people must have access to emergency care when they need it.”
Krupesh Hirani, Labour London Assembly Member for Brent and Harrow (London Assembly)
Mr Hirani, who represents Brent and Harrow on the Assembly, added: “Good oral health is essential for overall wellbeing. There are things we can do to look after our teeth, but we should be able to get an appointment when it is needed. Access to healthcare should be a right not a privilege, and that includes dentistry.
“London should smile with pride at its dental care – that sadly isn’t the case at the moment.”
Responding to the committee’s report, a spokesman for Sir Sadiq said: “The mayor has no powers over the commissioning or provision of dental or other health care, but he is concerned about the challenges many Londoners face accessing dental services, following significant cuts by the previous Government.
“He is encouraged by the new Government’s focus on improving NHS services and welcomes its Dentistry Rescue Plan which aims to prevent poor dental health. The mayor will respond to the Assembly in due course.”
The committee also recommended that the Government “carry out a review to understand why poor oral health is so prevalent across the country, and develop an action plan to address this”.
A spokeswoman at the Department of Health and Social Care said: “This Government is committed to rebuilding NHS dentistry, but it will take time.
“We are starting with an extra 700,000 urgent dentistry appointments to help those who need it most, supported by a £26 billion funding boost for health and social care, and will reform the dental contract to encourage more dentists to offer NHS services to patients.
“We will also introduce supervised tooth brushing for three-to-five year-olds in the most deprived communities.”