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Oral Health in the Isle of Man

Steps the Government is taking

Recommendations for oral health

In response to the Report of the Social Affairs Policy Review Committee (SAPRC), the Council of Ministers made a series of recommendations, which were endorsed by Tynwald, with the aim of reducing tooth decay and dental caries in children in the Isle of Man.

Public Health are working on the following recommendations:

Combining the implementation of two similar strategies - Oral Health Strategy (Public Health) and Dental Strategy (DHSC)

Following the Public Health Oral Health Needs Assessment, we developed a strategy for improving the oral health of children aged 0 – 11 years on the Isle of Man. This Implementation Plan is to be amalgamated with the Dental Strategy implementation plan. This was laid before Tynwald in October 2023 and replaces the two individual strategies in order to avoid duplication of work, and encourage greater collaboration between government departments.

View the Amalgamated Implementation Plan on the Tynwald Register of Business

Read more about our original Oral Health Strategy and Implementation Plan for 2021 - 2026 and the Department of Health and Social Care Dental Strategy.

Smile of Mann relaunch in nurseries, pre-schools and school years Reception and Year 1

Smile of Mann logo

In 2018, Public Health launched Smile of Mann, a supervised toothbrushing programme for all nurseries and pre-schools in the Isle of Man, with the aim of helping towards improving the oral health of young children here. Smile of Mann was set up as an optional programme that all nurseries and pre-schools were able to take part in, free of charge. In September 2022, the programme was opened up to all Reception and Year 1 classes of the Island’s primary schools, although only three schools signed-up.

The recommendations suggested that Smile of Mann is relaunched from September 2023, with the intention of participation being advised to all nurseries and pre-schools, and being delivered more widely across school years Reception and Year 1.

The programme will be evaluated in October 2024 to determine if it has been successful in developing healthy routines and any impact it has had on the oral health of 5 year olds in the Isle of Man. 

Exploring the fluoridation of water as a public health intervention

One recommendation was for Public Health to prepare:

  • A research paper to be considered by the Council of Ministers exploring the fluoridation of water, including:

    • What are the effects of water fluoridation on population health?

    • To what extent does water fluoridation reduce levels of tooth decay?

    • Is water fluoridation a more efficient and effective way of preventing tooth decay in children than targeted fluoride varnish application?

  • A report to Tynwald including the research paper, with any conclusions and recommendations

Why we are exploring fluoridation of water

The possibility of fluoridating Manx water was last explored in 2008, and discussed further in 2014. At this time, it was decided against. In the meantime, further research has been completed on water fluoridation so this new research paper will help to bring the evidence up-to-date so that the Council of Ministers can make an informed decision about what to do next.

About the research paper and its publication date

Many jurisdictions have already undertaken the process of adding fluoride to their water systems, so we will study any peer-reviewed research on the topic to gather evidence of the effect it may have if introduced into Manx drinking water. The aim will be to provide sufficient evidence for the Council of Ministers to determine whether it would be a more efficient and effective way of preventing tooth decay in children than targeted fluoride varnish application.

When the research paper is released, we will also share our search strategies for people who might be interested in carrying out their own search in the same way.

Some current information on water fluoridation is available in the Better Oral Health European Platform: Fluoridation in water.

Research paper completion date

It will be considered by the Council of Ministers in December 2023, and then included as part of the broader report, which will be laid before Tynwald by February 2024 and published on the Register of Business ahead of this sitting.

Next steps

After we have completed the research paper and submitted it to the Council of Ministers, we will compile a report giving suggestions based on evidence in the research paper, and wider policy considerations around the fluoridation of Manx water. This report will be submitted on the Tynwald Register of Business ahead of the February 2024 at which time it will be publicly available.

About fluoride and the process of putting it into water systems

Fluoride is a mineral that helps to prevent tooth decay, and brushing your teeth thoroughly with fluoride toothpaste twice a day is one of the most effective ways of preventing tooth decay. Children and adults in the Isle of Man are recommended to use family fluoride toothpaste (1,350 - 1,500 parts per million fluoride – ppmF) for maximum cavity control.

Fluoride is naturally occurring from soils and rock, and in many places, there are already natural levels of fluoride in the water supply. Manx water currently contains very low levels of natural fluoride (around 0.05 mg/l), and drinking water is not artificially fluoridated. The World Health Organisation upper limit for fluoride is 1.5mg/l. 

In many parts of the world, including some parts of the UK, fluoride is artificially added to the water.

An overview of water fluoridation in England.

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