NURSERY school pupils might be given fluoridated milk in a bid to tackle the high incidence of tooth decay among five-year-olds in County Durham.

The idea is part of a wider package of measures to address the problem, said consultant in dental public health, David Landes.

Mr Landes, who on Thursday becomes the acting director of public health in the Durham Dales, told the D&S Times that tooth decay was a disease of inequality and poverty.

"There are about 18 primary schools in the dales where two-thirds of children have experienced dental decay by the age of five," he said. "In the three primary care trusts in the southern part of the county, we have very high levels of dental disease."

A recent survey had shown that 60pc of five-year-olds in the dales - the only area in the region without a fluoridated water supply - had tooth decay, compared with a national average of 43pc. Sedgefield was a close second on 55pc.

Mr Landes said fluoridated milk was just one of the ways in which tooth decay could be tackled, along with the Sure Start programme which offered help and advice to parents, and the five-a-day fruit and vegetable campaign.

"The milk is one method shown to be effective, with the great advantage being that it can be targeted at areas with the highest levels of need," he added.

He stressed that if the measure was introduced, no child would be forced to drink fluoridated milk. If, after consultation, the idea was taken on board, then children from poorer backgrounds would be targeted. Milk would be offered to parents on the basis of whether children were at risk and individual consent would need to be given.

Members of Durham County Council's cabinet, to whom he had earlier addressed the issues, have taken on board his concerns.

Coun Christine Smith, lead member on health improvement issues, said that preliminary research by health visitors in the dales suggested that residents would not support the fluoridation of water supplies.

"We have contacted the health promotion service and it is firmly in favour of introducing milk fortified with fluoride into schools situated in areas where drinking water is not fluoridated," she added. "Bearing in mind that the dales fall into this category, the primary care trust intends to pursue a proposal to provide this milk to nursery pupils in the area.

"If the scheme is introduced, it could even be extended to all primary schools in the county, particularly to those receiving free school meals."

After agreeing to consult parents, head teachers and school governors on the proposal, cabinet members deferred a decision on supporting the general principle of introducing fluoridated milk until the results of the consultation and the results of a study by the University of Liverpool were known.