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The debate around whether fluoride should be added to tap water is not new.

The practice, which is aimed at reducing tooth decay, has been ongoing for 60 years.

But since fluoride toothpaste became more widely available around the 1970s, more questions have been raised about whether adding it to the drinking supply is still necessary.

And with Donald Trump’s health secretary pick Robert F Kennedy Jr saying he would ban it, the issue has entered public debate yet again.

Despite RFK being well known for his outlandish views on public health, it seems the fluoridation issue isn’t one that can be totally dismissed.

One study in the US has linked fluoride to a lowering of children’s IQs, while another in the UK has questioned its overall effectiveness when added to water.

So what is fluoride, what do experts say – and what’s the story in the UK?

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What is fluoride and what does it do?

It’s a natural mineral found in rocks, which leaches into soil, rivers and lakes.

It helps dental health by strengthening the tooth enamel, making it more resistant to tooth decay, and also reduces the amount of acid the bacteria on your teeth produce, according to the Oral Health Foundation.

Fluoride is known to be particularly beneficial for children’s teeth, as past studies have suggested ingesting it during the period of tooth development makes the enamel more resistant to later acid attacks and subsequent development of tooth decay.

Dr Kunal Patel, who has been a private and NHS dentist for 15 years, told Sky News the benefit of fluoride is “drilled into” dental students, adding there are “scientifically proven benefits of having fluoride within your oral hygiene regime”.

Fluoride is essentially a passive way of protecting your teeth, he says.

“If you decide not to use fluoride then the technique of brushing your teeth, your flossing and other methods of cleaning have to be that much better,” he adds.

How do we get fluoride?

Almost all water contains some naturally occurring fluoride, but it’s normally not enough to prevent tooth decay.

Some areas do have water supplies where the amount of fluoride is naturally at a high level – a point that will be covered later.

We get trace amounts of fluoride from much of our food and drink, but brewed tea in particular proves a big source because tea plants take up fluoride from soil.

Most toothpastes now contain fluoride to give you extra protection from decay.

When did adding it to the water supply become a thing?

Many oral health experts believe adding fluoride to water – an act known as fluoridation – is the most effective way to widely reduce dental problems, particularly in underprivileged regions.

The practice began in 1945 in Grand Rapids, Michigan, after scientists noticed that people had less tooth decay in areas with naturally higher fluoride levels in the tap water.

It was first added to the water supply in England in 1964, when a pilot scheme was launched in Birmingham.

Over the years it’s been rolled out to about 75% of America’s population, compared to about 10% of England.

The World Health Organization (WHO) estimates some 400 million people in 25 countries are getting artificially fluoridated water, while about 50 million have naturally occurring fluoride at the same level as the artificial schemes.

What is the ideal amount of fluoride in water?

The WHO recommends a maximum level of 1.5mg per litre.

In its guidelines, it says the level is aimed at creating a middle ground where tooth decay is minimised, but the risk of dental fluorosis and skeletal fluorosis is too.

Dental fluorosis is a common cosmetic condition caused by ingesting too much fluoride during tooth development, and can leave white flecks, spots or lines on teeth.

Skeletal fluorosis, a much rarer occurrence, is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride.

The UK government aims for fluoride levels of 1mg per litre in drinking water, while the level of fluoride is kept at about 0.7mg per litre in the US.

Potential danger to children’s IQs

Fluoridation has been a contentious subject in the US, with more than 100 lawsuits over the years trying to get rid of it without success, according to the American Fluoridation Society, an advocacy group.

And the anti-fluoride group Fluoride Action Network says more than 150 towns and counties across the US have voted to keep fluoride out of public water systems or to stop adding it.

But the movement against it really gained momentum earlier this year when a US government report concluded that fluoride in drinking water at twice the recommended limit was linked with lower IQ in children.

The report, based on an analysis of previously published research, said it reached its conclusion “with moderate confidence”.

It cited a 2019 study, published in the well-respected journal JAMA Pediatrics, which found that IQ levels were slightly lower in three and four-year-old children whose mothers had higher measures of fluoride in their urine when they were pregnant.

A federal judge in California used the report to order the nation’s Environmental Protection Agency (EPA) to strengthen its regulations on fluoridation in September, saying the current levels were posing an unreasonable risk to children.

The judge stressed that he was not concluding with certainty that fluoridated water endangered public health, but rather that it poses a risk.

Questions over fluoride’s effectiveness

In the UK, while the government is reviewing plans to raise fluoride levels for millions and roll it out into more areas of England, a major review has suggested fluoridation may only have a “modest” benefit.

Academics at Manchester, Dundee and Aberdeen universities compared 157 studies looking at the effect of fluoridation on the dental health of communities.

When the government began adding fluoride to tap water, it reduced the number of decayed, missing or filled teeth by two whole teeth on average among children with their baby teeth, researchers said.

However, once fluoride toothpaste became widely available, that number declined.

Now, it is equivalent to a reduction of a “quarter of a tooth” that is decayed, missing or filled, on average.

“Water fluoridation is only having a modest benefit on dental caries, and those benefits may take years to be realised,” said Professor Anne-Marie Glenny, of the University of Manchester, who co-authored the paper.

Could it actually be scrapped in the US?

Mr Kennedy Jr has claimed Mr Trump will push to remove fluoride from drinking water on his first day in office, referring to it as “industrial waste” in a statement on X.

He also claimed fluoride was associated with arthritis, bone fractures, bone cancer, neurodevelopmental disorders and thyroid disease.

While there have been studies regarding some of those claims, none of them have been conclusive.

After the comments, Mr Trump told Sky News’ US partner NBC News that while he had not spoken to his health secretary pick about trying to scrap fluoride yet, “it sounds OK to me. You know it’s possible”.

The decision on whether or not add fluoride to water is ultimately made by state and local health authorities, so Mr Trump’s government can only advise them to stop it.

‘It’s about risk vs benefit’

Stephen Peckham, professor of health policy at the University of Kent, previously led a study on fluoridation’s potential links to hypothyroidism – an underactive thyroid – and is now part of a research team investigating whether it could be causing IQ issues within the UK’s population.

He tells Sky News he accepts fluoride can be beneficial, but adds it is not a necessity, especially in water.

“We know that ingested fluoride is not an effective way of preventing tooth decay,” he says. “If you want to have fluoride, put it on your toothbrush and clean your teeth with it. It needs to be applied to the tooth and not swallowed.”

He says that while the benefit is limited, the children’s IQ study carried out in the US highlights a need for caution.

“What we do know is that ingesting fluoride does have a neurologic, neurotoxic effect. What’s less certain is at what level of fluoride that begins.

“The judge is saying, well, in that case, shouldn’t we be more careful? And limit in particular pregnant women’s access to fluoridated water or consumption of fluoridated water.

“And your maximum of fluoride depends on how much you drink. So if you drink more, you get more.”

It’s about the “balance of risk and benefit”, he says.

“But if there’s not much benefit, should you have any risk? The answer is no, you shouldn’t.”

‘Stick to the most deprived regions’

Dr Kunal Patel, who owns six private dental clinics in Surrey, including one for children only, says fluoridation was “great in a time where there was less education and less access to fluoride in toothpaste”.

He adds that before the IQ study came out, he would have been happy to see fluoride being added to any area in the UK because he’d have thought “anyone could benefit” without there being any negative effects.

Now, he says, he thinks it’s best to be “selective” and limit fluoridating water “to the areas that are suffering, where it’s more rural or more deprived”.

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He gives the North West as an example, saying he recently did a charity event there to promote dental health among young people, and it was “shocking” to see how many of them did not even own a toothbrush.

He says it’s a “good idea” to expand to similar areas of the UK where dental health is low – but thinks it would be an even better idea to provide toothpaste to schools in such areas and increase their education regarding how best to look after their teeth.

“I think education is the way forward more so than fluoridated water.”

A Department of Health and Social Care spokesperson told Sky News: “The number one reason children aged six to 10 end up in hospital is to have their rotting teeth pulled out.

“Water fluoridation at levels permitted in this country is a safe and effective public health measure that reduces tooth decay.

“Prevention is always better than cure, and this government is committed to helping people stay healthy and keeping kids out of hospital.”

Is your water being fluoridated?

About 330,000 people live in areas of England with naturally occurring fluoride in drinking water, while around 5.8 million people get an artificial supply put in theirs.

It means some 10% of people in England live in areas where fluoride is added to the water, mainly in the West Midlands and the North East.

There is no fluoridation in Wales, Scotland or Northern Ireland.

Here is the full list of areas receiving artificial fluoridation in England, according to the British Fluoridation Society:

  • Cumbria – 120,000
  • Cheshire – 137,000
  • Tyneside – 643,000
  • Northumbria – 101,000
  • County Durham – 85,000
  • Humberside – 136,000
  • Lincolnshire – 250,000
  • Nottinghamshire – 287,000
  • Derbyshire – 43,000
  • Birmingham – 1,000,000
  • Solihull – 200,000
  • Coventry – 300,000
  • Sandwell – 300,000
  • Dudley – 305,000
  • Walsall – 253,000
  • Wolverhampton – 236,000
  • Staffordshire – 497,000
  • Shropshire – 22,000
  • Warwickshire – 431,000
  • Worcestershire – 253,000
  • Bedfordshire – 198,000

And here is the list of areas getting the “optimal” amount of fluoride naturally:

  • Hartlepool, County Durham – 89,000
  • Easington, County Durham – 47,000
  • Uttoxeter, Staffordshire – 13,000
  • Redbridge, London Borough – 180,000

Where else could fluoride be added to water?

The Conservative government introduced proposals to expand fluoridation schemes across the North East “because of the significant and long-standing inequalities in the region” when it comes to dental health.

A public consultation on the plans was launched in June and closed in July. Since Sir Keir Starmer’s Labour government won the election, it has not been clear whether the plans are still being pursued.

These are the areas the government proposed extending the fluoride supply to:

  • Darlington
  • Durham
  • Gateshead
  • Hartlepool
  • Middlesbrough
  • Newcastle
  • Northumberland
  • North Tyneside
  • Redcar and Cleveland
  • South Tyneside
  • Stockton
  • Sunderland

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UK defence spending to rise to 2.5% of GDP by 2027 – as Starmer hits out at ‘tyrant’ Putin

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UK defence spending to rise to 2.5% of GDP by 2027 - as Starmer hits out at 'tyrant' Putin

Defence spending in the UK will increase to 2.5% of GDP by 2027 while the foreign aid budget will be cut, Sir Keir Starmer has said ahead of a meeting with Donald Trump.

Spending would be raised from the current 2.3%, with £13.4bn more on defence each year after 2027, the prime announced in an unexpected statement in parliament.

Sir Keir said he wants defence spending to increase to 3% of GDP in the next parliament, but that would rely on Labour winning the next general election, set for 2029.

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The number is much lower than the US president has demanded NATO members spend on defence, with Mr Trump saying they should all be spending 5% – an amount last seen during the Cold War.

Sir Keir also announced the government would cut back on foreign aid to fund the increase, reducing current spending from 0.5% of GDP to 0.3%.

Moments before the announcement, the Foreign Office said it was pausing some aid to Rwanda due to its role in the conflict in neighbouring Congo.

British Army soldiers from the 12th Armoured Brigade Combat Team during NATO exercises in May last year. Pic: Reuters
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British Army soldiers from the 12th Armoured Brigade Combat Team during NATO exercises in May last year. Pic: Reuters

Foreign secretary David Lammy just two weeks ago criticised Mr Trump’s decision to freeze USAID, saying development remains a “very important soft power tool” and is worried without it, he “would be very worried China and others step into that gap”.

Sir Keir said the reduction in foreign aid is “not a renouncement I’m happy to make”, as charities said the cuts would mean more people in the poorest parts of the world would die.

He reiterated the government’s commitment to NATO, which he described as the “bedrock of our security”, and criticised Russian President Vladimir Putin, saying “tyrants only respond to strength”.

Addressing his upcoming visit to the White House to meet Mr Trump, the prime minister said he wants the UK’s relationship with the US to go from “strength to strength”.

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Photo of Michael Clarke

Michael Clarke

Military analyst

Our defence budget should hit £67.6bn by 2025/26 then another £13.4bn onto that – that takes you to just over £80bn.

My guess is it won’t be spent on the heavy metal, it won’t be lots more tanks, not lots more aircraft or ships.

A lot of it will go, I think, into personnel which are the key elements and the thing we’ve seen degraded and degraded.

So, a lot of the money, I think, will go into transformational warfare, into cyber, into computing, into quantum computing, into being able to create what’s called a kill chain and a kill net, whereby you can see a threat, deal with it immediately, understand what it is immediately, and bring in exactly the right weapon to do something about it.

Even the United States, which is the most sophisticated in the world, you know, is constantly chasing that sort of, Philosopher’s Stone, of the kill.

The Russians aren’t very good at it at all. The Chinese, we don’t know how good they are.

We’re not really certain. But we’ve got to get much, much better at doing that.

So, I suspect a lot of this money will go on things that you won’t see immediately.

But I’m pretty sure also that this sort of money is fundamental to the sort of transformations which I suspect the defence review is going to talk about.

Conservative leader Kemi Badenoch welcomed the defence spending increase and said she had written to him over the weekend to suggest how he could redirect money from the overseas development budget.

“This is absolutely right,” she told the Commons.

“And I look forward to him taking up my other suggestion of looking at what we can do on welfare.”

She urged him to not increase taxes further or to borrow more to fund the rise, but to ensure the economy grows to support it.

Former Conservative defence secretary Ben Wallace said an extra 0.2% was “a staggering desertion of leadership”.

“Tone deaf to dangers of the world and demands of the United States,” he wrote on X.

“Such a weak commitment to our security and nation puts us all at risk.”

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‘Is US a threat to UK interests?’ Sky asks Badenoch

Labour MP Sarah Champion, chair of the international development committee, said cutting the foreign aid budget is “deeply shortsighted and doesn’t make anyone safer”.

“The deep irony is that development money can prevent wars and is used to patch up the consequences of them, cutting this support is counterproductive and I urge the government to rethink,” she wrote on X.

Charities condemned the cut, with ActionAid saying cutting the aid budget to fund the military “only adds insult to injury” and “flies in the face of UN charters”, adding it was a “political choice with devastating consequences”.

Christine Allen, CEO of CAFOD (Catholic Agency for Overseas Development), said the cut means “in some of the most vulnerable places on earth, more people will die and many more will lose their livelihoods”.

She said the cut, coming just after the US froze its aid programme, “is another lifeline being pulled away from those in desperate need”.

Labour promised in their manifesto to increase defence spending to 2.5% of GDP from the current 2.3%, however, ministers had previously refused to set out a timeline.

They had insisted a “path” to get to 2.5% would be set out after a defence spending review is published this spring.

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Remains of British man who vanished more than two years ago found in Georgia woods

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Remains of British man who vanished more than two years ago found in Georgia woods

The remains of a British man who went missing on a trip to Florida nearly two-and-a-half years ago have been found, the FBI has said.

Alex Hodgson Doughty was on holiday in Jacksonville in September 2022 when he was reported missing by his mother after she was unable to contact him.

His remains were found 35 miles north of there in a wooded area on private land near Kingsland, Georgia, the FBI said on Friday.

Overseas missing persons charity LBT Global said on a web page dedicated to Mr Doughty that he was last seen on 11 September 2022.

He was at a Jacksonville bar and grill at around 3.30pm and then got into a taxi which dropped him off in Kingsland around an hour later.

A Facebook page, Help Find Alex, said he continued to make video calls and send text messages up until 6.51pm when his phone went offline.

Federal, state, local, and international agencies were involved in the investigation and search for Mr Doughty, who was 30 when he went missing.

His remains were found on 4 February, the FBI said, adding a medical examiner had confirmed Mr Doughty’s identity.

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“While we had hoped to bring Mr Doughty’s family better news, we are thankful to be able to provide them with some closure,” said special agent Kristin Rehler.

“This discovery is the direct result of our partnerships and special agents from FBI Jacksonville’s Cellular Analysis Survey Team (CAST), who were relentless in their efforts to narrow down potential search locations.”

No criminal charges are expected, the FBI said.

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Yvette Cooper calls for new Runcorn MP after Amesbury jailed – but will keep his £91,000 salary

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Yvette Cooper calls for new Runcorn MP after Amesbury jailed - but will keep his £91,000 salary

Home Secretary Yvette Cooper has said Runcorn needs a new Labour MP after Mike Amesbury was jailed for beating up a constituent – and will keep his £91,000 MPs salary in prison.

She told Wilfred Frost on Sky News Breakfast: “Whether it is resigning or through recall, everyone’s clear – the people of Runcorn deserve better representation, and that would come by having a newly elected MP.”

Amesbury, who has been an MP since 2017, remains as the MP for Runcorn and Helsby after being jailed for 10 weeks on Monday.

He had at an earlier hearing pleaded guilty to assaulting Paul Fellows, 45 by punching him to the ground and hitting him five more times in Frodsham, Cheshire, after a night out last October.

He has not resigned, despite calls for him to do so.

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The 55-year-old MP will keep receiving his £91,000 salary while in prison because parliamentary rules state a recall petition, which kickstarts a by-election, can only happen once an appeal period for a custodial sentence of a year or less is exhausted.

Amesbury’s lawyer stated in court he would be appealing the 10-week sentence, of which the MP will serve four weeks in HMP Altcourse in Liverpool.

There is also no mechanism to stop pay for MPs, unless they are suspended from the House of Commons, which has not yet happened for Amesbury.

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CCTV shows Labour MP punch man

Ms Cooper added: “It’s completely unacceptable what has happened. No matter who you are. No one is above the law.”

On whether the government is considering changing the law so MPs who receive a prison sentence can no longer serve as an MP, Ms Cooper said: “I think these are matters, obviously, for the parliamentary authorities and processes that is separate from the decisions government make.

“But we are clear we need a new representation in Runcorn.”

Conservative shadow minister Victoria Atkins told Sky News the public and MPs have been “disgusted” by Amesbury keeping his job and called for the rules to be changed.

“I find it extraordinary that someone can claim their salary from their prison cell when their job is to be here in parliament, representing their constituents,” she said.

“I think the government needs to look at this and we will look at these measures very, very carefully, whatever they bring forward.

“I share the public’s disgust that a Labour MP is sitting in prison, serving a prison sentence because he beat up a constituent.”

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Mike Amesbury
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Mike Amesbury punched Paul Fellows to the ground then punched him five more times

Amesbury was suspended by Labour two days after the incident, after CCTV footage was widely distributed.

He has been sitting as an independent since then and Labour has said he will not be admitted back in.

Reform UK has also called for Amesbury “to do the honourable thing and resign immediately”.

Amesbury pleaded guilty to assault by beating in January and described the incident as “highly regrettable” and apologised to Mr Fellows and his family outside the court.

After the judge left the courtroom in Chester on Monday, following sentencing, Amesbury’s lawyer asked for him to return and requested bail while he appealed the sentence.

Judge Tan Ikram returned to the court, sat down, paused briefly and said: “Application refused.”

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