Fluoridation

Fluoridation, as the name suggests, is the addition of a fluoride to the water supply in order to prevent dental decay.

Benefits

Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults. By preventing cavities, community water fluoridation has been shown to save money both for families and for the US health care system.

Fluoride benefits children and adults throughout their lives. For children younger than age 8, fluoride helps strengthen the adult (permanent) teeth that are developing under the gums. For adults, drinking water with fluoride supports tooth enamel, keeping teeth strong and healthy. The health benefits of fluoride include having:

• Fewer cavities.
• Less severe cavities.
• Less need for fillings and removing teeth.
• Less pain and suffering because of tooth decay.

How does it work?

Fluoride has been proven to protect teeth from decay. Bacteria in the mouth produce acid when a person eats sugary foods. This acid eats away minerals from the tooth’s surface, making the tooth weaker and increasing the chance of developing cavities. Fluoride helps to rebuild and strengthen the tooth’s surface, or enamel. Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping the tooth strong and solid, fluoride stops cavities from forming and can even rebuild the tooth’s surface.

Fluoride

The mineral fluoride occurs naturally on earth and is released from rocks into the soil, water, and air. All water contains some fluoride. Usually, the fluoride level in water is not enough to prevent tooth decay; however, some groundwater and natural springs can have naturally high levels of fluoride.

Community water fluoridation

Community water fluoridation is the process of adjusting the amount of fluoride in drinking water to a level recommended for preventing tooth decay.

Although other fluoride-containing products, such as toothpaste, mouth rinses, and dietary supplements are available and contribute to the prevention and control of tooth decay, community water fluoridation has been identified as the most cost-effective method of delivering fluoride to all, reducing tooth decay by 25% in children and adults.

History of Fluoride in Water

In the 1930s, scientists examined the relationship between tooth decay in children and naturally occurring fluoride in drinking water. The study found that children who drank water with naturally high levels of fluoride had less tooth decay.2 This discovery was important because during that time most children and adults in the United States were affected by tooth decay. Many suffered from toothaches and painful extractions—often losing permanent teeth, including molars, even as teenagers.

Grand Rapids, Michigan

After much scientific research, in 1945, the city of Grand Rapids, Michigan, was the first to add fluoride to its city water system in order to provide residents with the benefits of fluoride. This process of testing the water supply for fluoride and adjusting it to the right amount to prevent cavities is called community water fluoridation.

CDC hails water fluoridation

• CDC Since 1945, hundreds of cities have started community water fluoridation and in 2016, nearly 73% of the United States served by community water systems had access to fluoridated water.
• Because of its contribution to the dramatic decline in tooth decay over the past 75 years, CDC named community water fluoridation as 1 of 10 great public health achievements of the 20th century.

US-fluoridation-1992-2006

Source of fluoride

The primary sources for fluoride intake include drinking water in fluoridated communities, toothpaste (if swallowed by young children), beverages and food processed with fluoridated water, dietary prescription supplements that include fluoride (e.g., tablets or drops), and other professional dental products (e.g., mouth rinses, gels, and foams).

Toothpaste with fluoride

Children should start using toothpaste with fluoride when they are 2 years old. For children younger than 2, consult first with your doctor or dentist regarding the use of fluoride toothpaste. CDC recommends that children under 6 use a small, pea-sized amount of toothpaste, spit out the excess paste, and rinse well after brushing.

Other dental products with fluoride

In addition to toothpastes, other dental products such as mouth washes may contain fluoride. If so, they are regulated as drugs by the FDA and will be clearly labeled regarding ingredients, directions for use, and warnings, if any. Fluoride-containing products are safe and effective when used as directed, but young children (under age 6) should not use fluoride mouth rinse unless directed to do so by a dentist or doctor. Similarly, very young children (less than 2 years old) should only use toothpaste with fluoride if the child’s dentist or doctor recommends it.

Latest research

• Most recent articles
• Ongoing trials
• Water fluoridation for the prevention of dental caries.

Iheozor-Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny AM. Cochrane Database Syst Rev. 2015 Jun 18;2015(6):CD010856. doi: 10.1002/14651858.CD010856.pub2. PMID: 26092033 Free PMC article. Review. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence. OBJECTIVES: To evaluate the effects of water fluoridation (artificial …

• Systemic Effects (Risks) of Water Fluoridation.

Cury JA, Ricomini-Filho AP, Berti FLP, Tabchoury CP. Braz Dent J. 2019 Oct 7;30(5):421-428. doi: 10.1590/0103-6440201903124. eCollection 2019. PMID: 31596325 Free article. However, the use of fluoride in water to control caries has created a controversy due to data associating water fluoridation as the cause of some systemic diseases. Therefore, the aim of this descriptive review was to discuss the systemic effects (risks) of …

• The costs and benefits of water fluoridation in NZ.

Moore D, Poynton M, Broadbent JM, Thomson WM. BMC Oral Health. 2017 Nov 28;17(1):134. doi: 10.1186/s12903-017-0433-y. PMID: 29179712 Free PMC article. BACKGROUND: Implementing community water fluoridation involves costs, but these need to be considered against the likely benefits. ...CONCLUSIONS: Community water fluoridation remains highly cost-effective for all but very small communities. ...

• Economic Evaluation of Community Water Fluoridation: A Community Guide Systematic Review.

Ran T, Chattopadhyay SK; Community Preventive Services Task Force. Am J Prev Med. 2016 Jun;50(6):790-796. doi: 10.1016/j.amepre.2015.10.014. Epub 2016 Jan 6. PMID: 26776927 Free PMC article. Review. CONTEXT: A recently updated Community Guide systematic review of the effectiveness of community water fluoridation once again found evidence that it reduces dental caries. ...Additionally, two of the six studies analyzed the cost effectiveness of community water …

FAQ

• How do I know if my water is fluoridated?

Check with your water supply source. Most municipalities and towns in the developed world use fluoride in their water supply including the United States.

• What does fluorine do in water?

Fluoride helps reduce dental decay.

• Can Fluoride make you sick?

Too much fluoride can cause many health problems

• Is Ohio water fluoridated?

Yes.

• Is South Lake Tahoe water fluoridated?

Yes

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Fluoridation Resources
Latest articles Most recent articles Ongoing trials	Wikipedia