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Water Fluoridation Still Lacking in Many Communities

July 15, 2005

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Even 60 years after the introduction of community water fluoridation -- one of the great public health successes of the 20th Century -- about one third of Americans still don't have access to this most economical method of fighting dental disease.

"It's dismaying that so many communities have failed their residents in this fashion," says American Dental Association (ADA) President Richard Haught, DDS. "Community water fluoridation benefits everyone, including those who, tragically, lack access to appropriate dental care."

"Community water fluoridation is the single most effective public health measure to prevent dental decay and improve oral health over a lifetime for both children and adults," says U.S. Surgeon General Dr. Richard H. Carmona. "I join previous Surgeons General in acknowledging the continuing public health role for community water fluoridation in enhancing the oral health of all Americans."

"Studies prove water fluoridation continues to be effective in reducing dental decay by 15 to 40 percent," says Dr. Haught. "This is true even in an era where there is widespread availability of fluoride from other sources, such as fluoride toothpaste."

"Because it reaches all people in a community regardless of education or income level, it is a powerful strategy in our efforts to eliminate differences in oral health among our citizens," explains William R. Maas, D.D.S., M.P.H., director, CDC Division of Oral Health.

How fluoride works

Tooth decay is an infectious and transmissible bacterial disease. When a person eats sugar, or other refined carbohydrates, some oral bacteria produce acid that removes minerals from the surface of the tooth, a process known as demineralization. If the demineralization process continues for a period of time, it leads to a cavity. Fluoridation helps reverse the demineralization process, preventing the cavity.

In 1945, Grand Rapids, Mich., became the first community to adjust the fluoride content in the public water system to the level effective for prevention of tooth decay.

Since then, some 170 million Americans, including residents of 44 of the nation's 50 largest cities, have benefited from optimally fluoridated water.

Key Facts

• Water fluoridation is the addition of fluoride to raise the natural concentration of fluoride in a community's water supply up to the level recommended by the U.S. Public Health Service for optimal dental health-0.7 to 1.2 parts per million (One part per million is the equivalent of about 1 inch in 16 miles or 1 cent in $10,000).

• Dental caries, commonly known as tooth decay or cavities, is an infectious multifactorial disease in which acid from bacteria dissolve the enamel of a tooth. This often results in pain and loss of tooth structure.

Fluoride works by keeping the tooth strong by preventing the loss of minerals from the enamel as well as facilitating the remineralization or uptake of minerals into the tooth.

• A recent review by the U.S. Task Force on Community Preventive Services strongly recommended community water fluoridation for reducing tooth decay. For the many studies reviewed, there was a median 29 percent reduction in tooth decay among children and adolescents.

• Community water fluoridation benefits everyone, especially those without access to regular dental care. It is the most efficient way to prevent one of the most common childhood diseases - tooth decay (5 times as common as asthma and 7 times as common as hay fever in 5- to 17-year-olds).

Without fluoridation, there would likely be many more than the estimated 51 million school hours lost per year in this country because of dental-related illness.

• Currently, 67 percent of Americans on public water systems receive optimally fluoridated water.

• Fluoridation is cost effective. For most U.S. communities, every dollar spent on community water fluoridation results in a savings of $38 in treatment costs.

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