Community Water Fluoridation

         The process of enhancing the fluoride content of drinking water to a level suggested for cavity prevention in teeth is known as community water fluoridation. Fluoridating communal water benefits everyone in the community by preventing cavities, lowering disparities in oral health, and saving money.

It has been proven that fluoride guards against tooth decay. Through mineral replenishment, it aids in the reconstruction and strengthening of the tooth's enamel. Younger children's teeth are strengthened while they are still developing, and as adults' gums recede with age, it helps prevent tooth decay.

Benefits of Community Water Fluoridation

Prevention of Tooth Decay

Fluoride is effective for children and adults and works very well to prevent tooth decay. Topically, it makes teeth more robust and more resistant to decay. Topically applied fluorides are incorporated into developing tooth structures, protecting from within (American Dental Association, n.d.; Mississippi State Department of Health, n.d.).

Safety and Effectiveness

Most health authorities in the United States, such as the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC), regard fluoridation of community water as a safe and effective means of reducing cavities. The CDC further provides operationalized recommendations on full health benefits against the lowest possibility of hazards regarding fluoride levels in water (CDC, 2016-2021). The ADA also says that because fluoride is naturally present in water, its controlled addition effectively benefits dental health.

Cost-Effective

Community water fluoridation is a public health measure considered cost-effective. It reduces the need for dental treatment and saves money for individuals and healthcare systems. Mainly, it benefits low-income populations who have no regular access to dental health care (Mississippi State Department of Health, n.d.; ADA, 2024).

It’s Natural

Fluoride is naturally present in groundwater and the oceans. Fish and vegetables are among the foods that naturally contain fluoride. When naturally occurring fluoride levels are too low, water fluoridation raises the fluoride content of tap water to a recommended level in an effort to prevent tooth decay.

Protects all ages

            According to studies, fluoride in public water systems protects children's and adults' teeth from decay by at least 25%. Compared to similar youngsters who do not live in fluoridated settings, schoolchildren in fluoridated communities typically had 2.25 fewer cavities. (Mississippi State Department of Health, n.d.; ADA, 2022)

Accessibility

Fluoridated water affords uniform protection to all individuals, irrespective of age, income, or other forms of accessibility to any dental service. It, therefore, is an equitable means toward improving oral health (ADA, n.d.).

Disadvantages of Community Water Fluoridation

Risk of Fluorosis

Too much ​​fluoride ingestion during the developmental stage of teeth can result in fluorosis. This can be in the form of white striations or stained pitting of the enamel of teeth. At worst, it can cause a disturbance in the whole structure of the teeth (ADA, n.d.; National Institutes of Health, n.d.).

Ethical Concerns

Adding fluoride to public water supplies is sometimes considered a mass medication without individual consent. Such a practice raises issues concerning personal rights and autonomy (Fluoride Alert.org, n.d.).

Health Concerns

There have been claims forwarded by critics that there are potential adverse health impacts of fluoride, including links between the chemical and thyroid problems and neurological issues, among other health concerns. NIH categorizes health links with fluoride as inconclusive and cites inconclusive evidence (National Institutes of Health, n.d.; Connective Tissue Research Society, 2023).

Environmental Impact

The worry lies within the ecological impact of fluoridation chemicals on local ecosystems and wildlife because of the chance it might end up in natural water bodies through wastewater discharge (Fluoride Alert.org, n.d.).

New on Fluoride Material

Effect of fluoridation on people with Chronic Kidney Disease (CKD)

For those with moderate renal disease, fluoridation poses no health hazards, according to the National Kidney Foundation. Nonetheless, skeletal fluorosis may be a concern for those with end-stage renal disease, despite a lack of research on the subject. Dialysis machines' fluoride concentrations must adhere to prescribed standards.

CDC's Position on Fluoride Safety and Cost-Effectiveness

The CDC strongly believes that community water fluoridation is a safe and effective process and offers a massive deal of savings regarding dental treatments. If removed, it would inflict an enormous impact on low-income families since water is their only means of dental preventive care (CDC, 2024).

Recent Study on Fluoride Benefits

According to a recent study by Medical Xpress, although fluoride in drinking water considerably lowers dental treatments, it does not necessarily cut social disparities in dental health. The study indicates that optimal fluoride levels still provide a payback against other public health initiatives, only managing relatively small reductions in dental visits (Medical Xpress, 2024).

Emerging Issues in Fluoridation

The American Dental Association has continued to address emerging issues in community water fluoridation, such as the development of new technologies for fluoridation and the controversy surrounding the neurotoxicity of fluoride and its effect on IQ. ADA supports water fluoridation as a significant public health policy (ADA, 2024).

Fluoride and Skeletal Fluorosis

An article in the journal of the Connective Tissue Research Society relates to the possible public health and environmental challenges of skeletal fluorosis, reported to be rare and attributed to excessive fluoride concentration in long-term exposure. It may require, therefore, extra special care for the management of fluoride levels to prevent the occurrence of such health hazards (Connective Tissue Research Society, 2023).
References

American Dental Association. (2024). Recent Fluoridation Issues. https://www.ada.org/resources/community-initiatives/fluoride-in-water/recent-fluoridation-issuesLinks to an external site.

American Dental Association. (n.d.). Fluoride: Topical and Systemic Supplements. https://www.ada.org/en/resources/ada-library/oral-health-topics/fluoride-topical-and-systemic-supplementsLinks to an external site.

Centers for Disease Control and Prevention. (2016-2021). Community Water Fluoridation Levels To Promote Effectiveness and Safety in Oral Health — United States. https://nccd.cdc.gov/DOH_MWF/Links to an external site.

Connective Tissue Research Society. (2023). Skeletal Fluorosis: Public Health and Environmental Challenges. https://www.tandfonline.com/doi/full/10.1080/15376516.2023.2268722Links to an external site.

Fluoride Alert.org. (n.d.). 10 Facts About Fluoride. https://fluoridealert.org/fan-tv/10-facts/Links to an external site.

Fluoride Alert.org. (n.d.). https://fluoridealert.org/fluoridation.htmLinks to an external site.

Medical Xpress. (2024). As bans spread, fluoride in drinking water divides communities across the US.https://medicalxpress.com/news/2024-04-fluoride-communities.htmlLinks to an external site.

Medical Xpress. (2024). Future benefits of water fluoridation are not guaranteed, study shows. https://medicalxpress.com/news/2024-01-future-benefits-fluoridation.htmlLinks to an external site.

Mississippi State Department of Health https://msdh.ms.gov/page/43,24339,151,220.html

Mississippi State Department of Health. (n.d.). Benefits of Community Water Fluoridation. https://msdh.ms.gov/page/resources/20267.pdfLinks to an external site.

National Institutes of Health. (n.d.). Fluoride. https://ods.od.nih.gov/factsheets/Fluoride-HealthProfessional/Links to an external site.