A FRESH attempt to have fluoride added to Glasgow's water supply was launched yesterday amid concerns over the safety and effectiveness of the process.
Ministers have still to decide whether to implement fluoridation across Scotland, but in Glasgow public health officials have urged the Scottish Executive to do so ''at the earliest possible time''.
The Greater Glasgow NHS Board is to hold a public consultation on the issue, and there will be a decision in December.
The executive aims to raise the number of five-year-olds with no dental disease from 45% across Scotland to 60% by 2010. Many public health experts believe this to be unattainable without fluoridation of the water supply.
Glasgow has the worst record for oral health in Scotland and one of the poorest in Europe, with children from the most deprived areas having the most serious decay.
In places such as Moray, where the water supply is naturally fluoridated, and Newcastle and Birmingham, where fluoride is deliberately added, children at the ages of five and six have greater than 90% fewer decayed teeth than those living in non-fluoridated areas.
Such statistics have helped persuade Greater Glasgow NHS Board to begin a third attempt to add fluoride to the city water supply, knowing the previous attempts failed in the face of public opposition and legal challenges.
The Scottish Executive's long-delayed response to the public consultation on fluoridation is expected in the autumn. The consultation period was extended because of the overwhelming number of responses it attracted.
Fluoride is not added to the water supply anywhere in Scotland and, without the blessing of ministers, the health board is thought to be powerless to act, but is clearly determined to maximise public support for its stance in the meantime.
Health authorities in England and Wales already have the power to force water companies to add fluoride to the water supply, so long as the local community approves.
The British Dental Association says fluoridation is safe and does not infringe on civil liberties. It supports targeted water fluoridation in areas with high levels of tooth decay.
Computerised technology used by Scottish Water to control supply means some areas can have fluoride added to their water while others can remain fluoride free.
Opinion remains divided on the Greater Glasgow Health Board, with medical professionals broadly in favour of adding fluoride and lay members more cautious.
A report on oral health put before the board yesterday states: ''It is widely acknowledged that the biggest single impact to improve oral health could be achieved through increased and sustained exposure to fluoride.
''Greater Glasgow's residents are disadvantaged by the low level of naturally occurring fluoride in the public water supply. We acknowledge there is some opposition to water fluoridation but believe that much of this opposition is based upon spurious claims relating to unsubstantiated effects of fluoride upon health.
''We believe that the withholding of optimally fluoridated public water unnecessarily disadvantages Glasgow's population.''
Dr Frank Angell, chair of the area dental committee, de-clared himself in favour of fluoridation, but said he welcomed a public consultation and debate to debunk some of the myths behind it.
Agnes Stewart, a lay member of the board, said she was concerned by reports that fluoride can exacerbate certain medical conditions, adding: ''I notice one English board held up as an example has withdrawn fluoride. I also want to be assured that the board will consider its papers on the side effects.''
But Dr Harry Burns, public health director, said the concentrations of fluoride being proposed were well within the safe limits, and side effects had only been detected in places such as India, where concentrations are very high.
The fluoride saga
1978 - Strathclyde Regional Council approved mass fluoridation of the water supply by a single vote. This prompted Catherine McColl, a pensioner from the Gorbals, to mount a legal challenge to the decision. She was represented by Peter McCann, a former Lord Provost of Glasgow.
1982 - After 201 days and 1434 pages of evidence, Lord Jauncey ruled that Strathclyde had exceeded its authority in recommending the addition of the chemical. McColl v Strathclyde Regional Council was the longest-running civil action in Scottish legal history until the Piper Alpha case.
1992 - Greater Glasgow Health Board made moves to reopen the fluoride in water question, but the attempt again fell on stony ground amid a huge public outcry.
2004 - Another proposal from the health board is made on the back of a Scotland-wide consultation on fluoridation by the executive. The findings of ministers and the board will be made public later this year.