The report says it provides further reassurance that water fluoridation is a safe and effective public health measure (Public Health England, 2014). Key findings are that for five-year-olds there are on average 15% fewer with tooth decay in fluoridated areas than non-fluoridated areas. In addition, when deprivation and ethnicity are taken into account, 28% fewer five-year-olds have tooth decay in fluoridated areas. For 12-year-olds on average, there are 11% fewer with tooth decay in fluoridated areas and when deprivation and ethnicity are into account, 21% fewer. There are 45% fewer hospital admissions of children aged one to four for dental caries in fluoridated areas. Sue Gregory, director of Dental Public Health at PHE, commented: 'These findings highlight the important contribution that water fluoridation makes to children’s dental health and general well-being. 'It is notable that the benefits of this public health measure appear to be greatest for children living in the most deprived areas of the country. 'This is significant for reducing the large differences we see in dental health between deprived and more affluent areas of the country.' Public Health England also addresses the concerns people have over dental fluorosis. A previous study of fluoridated Newcastle upon Tyne and non-fluoridated Manchester found that the number of 12-year-old children with moderate dental fluorosis or more is very low, at around 1% in Newcastle and 0.2% in Manchester. The report admits that children in Newcastle upon Tyne are more likely than those in Manchester to develop fluorosis of any level. However, children in Newcastle have less tooth decay than those in Manchester. The report also finds that concerns about some general areas of health are unfounded. These include hip fractures, kidney stones, down’s syndrome, bladder cancer and osteosarcoma or other forms of cancer among under 25-year-olds. The British Dental Association’s scientific adviser, Professor Damien Walmsley, said: 'The report is a timely reminder of the significant role that fluoridation plays in reducing tooth decay, which remains a significant health problem in England. '(The report) also emphasises the important role it (fluoridation) plays in alleviating the misery of dental general anaesthesia in children. 'When tooth decay is a preventable disease, it’s depressing that so many children in England – at least 25,000 last year – have such extensive tooth decay that they need to have this procedure. 'Undergoing such an operation at a tender age can lead to life-long anxiety about having dental treatment, and so perpetuates a cycle of avoiding dental care until emergency treatment is required.' Public Health England will continue to keep the evidence base under review and will use this report ‘as part of an ongoing dialogue with local authorities’. Required by legislation, Public Health England must monitor the effects of water fluoridation schemes on the health of people living in the areas covered and to produce reports. References Public Health England. (2014) Water fluoridation: Health monitoring report for England 2014, London: Public Health England.