Water Fluoridation
A review of its history, controversy and mechanism of action
Fluoridation of our water systems has always been a controversial issue. This article will attempt to separate facts from fiction.
According to the American Dental Association, sixty-seven percent of American communities have public fluoridated water systems. Fluoridation of the first US public water system occurred in Grand Rapids, Michigan, on January 25th 1945. Studies and research, conducted by the ADA, have shown that community water fluoridation since that time, have reduced the caries rate in children, approximately twenty-nine percent. The optimal fluoride levels for these water systems ranges from .7 to 1.2 parts per million. Many other countries, however, do not fluoridate their water. Although the reasons vary with each country, none have discontinued or refused to adopt fluoridation due to any proven health problems.
History
In 1909 a dentist, by the name of Frederick McKay, was interested in knowing why some children, in the Pike’s peak region of Colorado, developed a brown, mottled stain on their teeth. Despite the negative appearance, it was noted that these children had a lower caries rate, than many other children. After consultation with another notable dentist, G.V. Black, the answer was found after twenty-two years of research and study, in 1931. It was discovered that the discoloration was due to fluoride ions. The mineral cryolite, which was abundant in the Pike’s Peak region, contained fluorine, which would wash out during the runoff of rain and snowstorms. It was discovered that the regional water concentrations ranged from two to thirteen parts per million.
In 1935, Dr. H.Trendley Dean, studied the caries rates of the children in the Colorado area. His studies concluded that the optimum level for fluoride would be one part per million. This amount would give the necessary caries protection , without the brown mottling of fluorosis. Dr. Gerald J. Cox in 1939, further proposed using fluoride with drinking water. Subsequent research and studies of fluoridated cities versus non-fluoridated ones, verified the decrease in the amount of caries in the fluoridated communities. In 1950, the ADA unequivocally accepted and encouraged the fluoridation of public water systems, as a means of caries prevention.
How it works
Some oral bacterium, that cause dental caries, use the sugar and carbohydrates that are found in our food supply, to produce acids that remove the minerals from the tooth. This is referred to as demineralization. Increased and prolonged demineralization of tooth structure leads to caries development. Fluoride reverses this process by adding minerals back to the tooth. It remineralizes tooth enamel, making the tooth more resistant to caries development.
The controversy
The main controversy with fluoride stems from the fact that sodium fluoride is the main ingredient in rat poison and fluoride in large concentrations can be extremely toxic. It has been proven that large amounts of fluoride can cause dental fluorosis. Opponents have tried to link fluoride to bone brittleness, cancer, reproductive problems and general poisonings. The main argument against opponents is that no valid scientific study on fluoridation has ever shown any health risk to humans. A 1991 study, by the Department of Health and Human Services, proved this to be accurate. Studies by the CDC and ADA have likewise shown similar results. The second argument is that toxicity and ill effects are directly related to fluoride concentration. The amount that's used in the public water systems is well below toxic levels.
Summary
The ADA has stated that fluoridation has been the single most effective public health measure to prevent dental caries. In small doses, it is extremely effective. Studies and research by the ADA have proven it to be safe. Fluoridating water supplies benefits all, especially those who don’t seek regular dental care. Without it, dental-related illnesses would increase, as would the costs associated with it.
References
Achievements in public health. 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries
Sprague, Bernhardt and Barrett. Fluoridation:Don't let the Poisonmongers Scare You!
