Fluoride in Community Water
Fluoride, a naturally occurring mineral, has been proven to inhibit and even reverse tooth decay. As a result of its benefits, Ontario began a program to fluoridated its water in 1945 as a preventative measure to reduce tooth decay. Today, nearly 80% of Ontario’s population have access to fluoridated water. However, like with many public health topics, community water fluoridation has had its proponents and opponents within certain circles of the medical community and the general public. An examination of global evidence and research will be discussed.
What’s so good about fluoride? Dental decay is caused from cariogenic bacteria in the mouth interacting with sugers/carbohydrates on the tooth surface. Over time, the tooth begins to demineralize and its hydroxyapatite crystalline breaks down, causing caries/decay. When fluoride is present, it reverses the demineralizing process by ‘remineralizing’ the tooth by forming fluorapatite, instead of hydroxyapatite. Fluorapatite is stronger and less soluble than hydroxyapatite, thus being more resistant to future demineralization. From a public health cost perspective, adding fluoride to water is a much more cost effective way to prevent tooth decay for people of different socioeconomic statuses. Similar to the idea of promoting regular exercise to prevent cardiovascular issues, the cost of adding fluoride to drinking water is minimal compared to the expensive costs of dental surgeries to treat decay.
Are there associated health risks found? In 2010, Health Canada released a 100 page report, entitled “Guidelines for Canadian Drinking Water Quality- Guideline Document-Fluoride“. In this document, it reviewed over 400 scientific papers and found no coorelation between community fluoridated water and adverse health effects at a level of 1.5mg/L. Note that the current utilized fluoride concentration in Ontario’s water is only 0.7mg/L, which is half of the 1.5mg/L concentration from the study. So even when the currently used concentration is doubled, no negative health effects were found.
What do other countries think? Other countries have found similar results. The U.S. Center for Disease and Prevention stated that “because of its contribution to the dramatic decline in tooth decay in the United States since the 1960s, the Centers for Disease Control and Prevention (CDC) named community water fluoridation one of 10 great public health achievements of the 20th century.” As recent as August 2015, the U.S. Surgeon General, Dr. Vivek Murthy published a report reaffirming the benefits of fluoridated water, as he writes, “community water fluoridation continues to be the most cost-effective, equitable and safe means to provide protection from tooth decay in a community.” From a global perspective, the World Health Organization believes that this move will “improve the quality of life and enhance the achievement of the Millennium Development Goals by reducing the high dental disease burden of populations, especially children in disadvantaged populations.”
The Wrap Up. Fluoride has been shown to be a safe and effective method to prevent dental decay to all members of a community. Its benefits are clear with no proven link to any adverse health risks. At Lee Dental Associates, our dental care at Avenue and Lawrence dentists, understand that people may have differing viewpoints and we fully respect them regarding treatment in our office. Feel free to discuss your opinions and wishes with our doctors during your dental visits.