By John Luther, DDS, Senior Vice President, Chief Dental Officer DentaQuest and Michael Monopoli, DMD, MPH, MS, Director of Policy and Programs DentaQuest Foundation
A recent recommendation by the U.S. Department
of Health and Human Services (HHS) has brought about a resurgence of support
for community water fluoridation within the oral health community.
Dentists have consistently been strong
advocates for the health benefits of fluoridating public water supplies, and
fluoridation is widely regarded as one of the top public health achievements of
the past century. Officials from both public health organizations and
professional dentistry agree that water fluoridation and fluoride toothpaste
are largely responsible for the significant decline in tooth decay in the U.S.
over the past several decades.
Fluoride doesn't cure or medicate -- it
simply prevents. Similar to a vitamin, the right amount of fluoride in our
drinking water improves resistance to tooth decay and causes us no harm. By
preventing tooth decay, community water fluoridation has been shown to save
money, both for families and the healthcare system.
In 2000, the U.S. Task Force on
Community Preventive Services examined 21 studies and concluded that
fluoridated water reduces tooth decay by a median rate of 29% among children
ages 4 to 17. While children are typically cited as the beneficiaries of this
protection, a 2010 study in the American Journal of Public Health (October
2010, Vol. 100:10, pp. 1980-1985) found that the fluoridated water consumed as
a young child makes the loss of teeth from decay less likely 40 or 50 years
later when that child is a middle-aged adult.
Recently, HHS announced the first change
in the recommended amount of fluoride for public drinking water supplies in
more than 50 years. The new guidelines utilize the best evidence available to
clarify the amount of fluoride needed to achieve the optimal amount of tooth
decay prevention.
The department gave several reasons for
the change, mainly citing that Americans have more access to sources of
fluoride than they did when water fluoridation was first introduced in the
1940s, but water is just one of multiple sources. Consumers also have access to
fluoride toothpastes, mouth rinses, and prescription fluoride supplements, as
well as fluoride applied by dental professionals.
We, along with the Centers for Disease
Control and Prevention, the American Dental Association, and many other
organizations, know that community water fluoridation is one of the most
cost-effective means of preventing dental caries. The new recommendation, along
with other current findings, strengthens our understanding of the preventive
effects of fluoride on oral health and reinforces the need for communities to
continue to invest in keeping fluoride in community water.
After more than 70 years of studying
fluoridation in drinking water, it is clear that this practice is one of the
most important health-promoting policies that a community can offer all its
residents. This is especially true for those who are low-income, those with
limited access to regular dental care, and those who experience health
disparities firsthand. It's effective. It's safe. And it's the reason why both
children and adults today have much less tooth decay than people had a
generation ago.