Executive Summary Report of a Programme of Research Commissioned by the Dental Health Foundation

A comprehensive programme of research was commissioned by the Dental Health Foundation between July and December 2000. It commenced with exploratory focus group discussions in July on the subject of fluoride in water. The results of these groups formed the basis of a questionnaire for a survey which was designed to explore and quantify public awareness of the issues surrounding dental health and water fluoridation. The survey questionnaire was included on a Lansdowne Market Research Omnibus survey of 1,180 adults aged 15+. The fieldwork was conducted between the 26th September and the 6th of October 2000. The survey sample was random, but quota controlled by sex, status, class, region and area to ensure representation of the adult population. In addition to the focus groups and the survey, monitored media between November '99 and December 2000 was subjected to content analysis in December 2000.

Conclusions were drawn across all of the findings. The results have been presented to the Department of Health and Children and The Forum on Fluoridation. The Dental Health Foundation now has a benchmark in time against which to monitor the progression of this issue.

Summary of Main Findings and Conclusions

Concern About Fluoride in Perspective

• When it comes to people's general concerns, fluoride in water was not a high level concern or very top of mind.


• less than a quarter were very concerned.


• By comparison, over half of those surveyed (50%) were very concerned about water pollution.


• If water fluoridation is seen as a water pollutant or an environmental issue then there is a higher level of concern.

• Most people appeared to be subliminally aware of fluoride's presence in their water supply (or not in the case of group schemes)


• information derived from a variety of sources- media, school, word of mouth.


• However, the level of interest, emotional involvement and concern about the issue remains low


• outside the hot housing environment of the focus groups many admitted to never thinking of/discussing the issue.

• A high level of misunderstanding exists about the purpose and function of fluoride and the specific benefits it can provide.


• It was often confused with chlorine and mistakenly perceived as a purifying or cleaning agent added to water to protect against pollutants and impurities.


• Its dental benefits/rationale were largely forgotten or often overlooked altogether.


• The rationale for fluoride in water is not as clear as it may have been in former years when Irish people were perceived to be less progressive in terms of dental care.


• There is acknowledged more awareness of dental health and the need for preventative care of one's teeth nowadays.


• There is a sense that Irish people's attitudes and behaviours have improved considerably.


• The Irish public does appear to be conscious of the dangers to children of ingesting excessive levels of fluoride from toothpaste.


• Parents in the main, did not appear to be actively monitoring or supervising their children's toothpaste usage.


• There was evidence in the survey generally of adults using fairly liberal amounts of toothpaste.


• The public appears to welcome the debate as indicative of a positive shift in Irish society.


• The public believes that an independent objective spokesperson or body would be credible in order to communicate a balanced perspective on this issue.


• Preference for an expert spokesperson with a scientific/evidence based background exists.


• Such a spokesperson/body needs to communicate the relevant information as follows;


• in layman's language


• drawing on concrete examples of international research on fluoride to demonstrate a cost benefit analysis.


• The issue of water fluoridation is perceived to be a general health issue as opposed to solely a dental health one.


• In the main, the issue and information regarding fluoride in water is seen to be the remit of the Department of Health and Children.


• Dentists are perceived to be credible spokespeople to communicate the benefit of fluoride to teeth


• not so much for the general health issues.


• Water quality and purification is linked in the public mind to fluoridation


• making it an environmental issue.