Fluoridation among top health achievements
The Centers for Disease Control and Prevention identifies fluoridation of drinking water as one of the 10 great public health achievements of the 20th century. The American Public Health Association promotes water fluoridation as the foundation for better oral health. Even in today’s environment, with the increasing availability of fluoride-containing products such as toothpastes and mouth rinses, community water fluoridation remains the most equitable and cost-effective method of delivering fluoride to all members of most communities, regardless of age, educational attainment, or income level.
Fluoridated water and tooth decay
Fluoride is the ionic form of the element fluorine, an element abundant in the earth’s crust. As a result, fluoride is a naturally occurring component of all water sources in varying concentrations. Fluoride protects teeth in two ways; systemically and topically. Systemic fluoride sources are ingested, sources include fluoridated water, dietary fluoride supplements, and fluoride in foods and beverages. Systemic fluoride present during tooth development becomes incorporated into the tooth structure, resulting in fortified enamel more resistant to decay. Topical fluorides are those applied on the tooth and provide local protection on the surface. Topical fluoride not only prevents demineralization and promotes remineralization in the enamel, it also inhibits the activity of cariogenic
bacteria. Fluoride’s topical effects explain why both adults and children benefit from fluoride exposure. Sources of topical fluoride include toothpastes, mouth rinses, professional dental products and saliva. Saliva is an important carrier of topical fluoride. While saliva secreted from the ducts contains a low level of fluoride not likely to have decay-preventing effects, drinking fluoridated water can greatly increase saliva’s fluoride concentration. Therefore, drinking fluoridated water provides both systemic and topical protection, resulting in maximum reduction in tooth decay.
Recommendations for using fluoride for optimal dental health
CDC provides recommendations to dental and health care providers, public health care officials and the general public for the best practices in fluoride use to prevent dental decay. In recent years, CDC reviewed and revised the recommendations to reflect the current environment of widespread availability of fluoride-containing products and multiple water sources, such as bottled waters and home water treatment systems.
Fluoridated community water
Fluoridated water contains the optimal level of fluoride, which can occur naturally or through the addition of fluoride to the community water supply (tap water). When the community water supply’s naturally occurring fluoride level is below the optimal level to reduce dental decay while minimizing the occurrence of dental fluorosis, the water can be fluoridated to increase the amount.
The optimum concentration for fluoride in water in the United States is 0.7 parts per million (ppm) to 1.2 ppm. Parts per million is equivalent to milligrams of fluoride to liter of water. Even in today’s environment, where other sources of fluoride are readily accessible and utilized, water fluoridation continues to be effective at reducing decay.
While CDC provides guidance and information to the officials responsible for formulating and implementing water fluoridation programs, it is not the regulatory agency. The United States Environmental Protection Agency (EPA), which is responsible for the safety and quality of drinking water in the United States, sets criteria for safe drinking water, including the maximum allowable concentration of fluoride to protect children and others from adverse health effects.
I urge you to discuss this issue with your dental professional and to refer to only scientific evidence based research, not “Google” based research.
Janis McClelland is a registered dental hygienist.