Costs of Water Fluoridation in England (UK) - 2013-2025
Revenue costs for the English Water Fluoridation programme increase every year and currently stand at over £5 million (2025 figures). If the North-East of England becomes fully fluoridated in 2026, we can expect an annual revenue cost of over £7 million. That's a lot of money to pay for a reduction of 3% in dental decay amongst 5-year-olds.
The entire topic of the cost of the UK's Water Fluoridation programme can be found as a technical report on Researchgate (LINK).
Costs have been obtained by sending successive FoI requests to Public Health England and to the Office for Health Improvement and Disparities.
Analysis
Revenue costs have increased each year since 2013 apart from 2019-20 when the supplier changed to Israel Chemicals Ltd.
The annual cost of hexafluorosilicic acid has risen from £877,336 i n 2014 to £2,772,084 in 2025. in that time there have been no new English water fluoridation programmes so the rise in cost is in account of an increase in population and inflation.
Revenue costs include the cost of replacing end-of-life fluoridation equipment.
All costs are met by the Department of Health and Social Care since 2022 which is 100% responsible for WF programmes and policy.
Local Authorities no longer have much of a say in initiating WF programmes although they can suggest to the Secretary of State that an area ought to go out to Public Consultation.
Capital costs of fluoridation equipment is a moveable feast. The least expensive seems to be £400,000 per Water Treatment Works whilst the equipment for Williamsgate Water Treatment Works in West Cumbria cost £1.6 million.
Elsewhere on this website, we have commented on the fact that 60% of the purchased hexafluorosilicic pours into sewage treatment works from homes and the service industry and half of that 60% ends up in rivers, streams and brooks on which Sewage Treatment Works are sited. The remaining half eventually ends up in sewage sludge some of which is spread on fields used fir growing crops. By this time the sludge is somewhat denatured although it still contains chemicals which were in the raw sewage. Thus fluoride often ends up in our fields and in our rivers.
40% of the hexafluorosilicic acid is lost during distribution as leakage, in industrial processes and as irrigation water.
Fluorides are "dangerous substances" in the aquatic environment (Directive 2006/11/EC retained) and must be controlled, so if the DHSC persists in rolling out the WF programme for England, its activities ought to have regard to the Directive. We await the Environment Risk Assessment promised by Earl Howe in the House of Lords in March 2022.
The DHSC has decided to foot the bill for ALL WF costs from 2022 onwards, so it may not be possible to obtain a breakdown according to the expenditure for each Local Authority, although we are able to provide a breakdown according to the type of cost.
The following spreadsheets provide total revenue costs of the English fluoridation programme since F/Y 2013.
Analysis of Costs from Fluoride Free Australia (FFA)
In this well-researched article, FFA explores the huge amount of public finance which is spent on purchasing the fluoridating acid.
