Second Opinion: No real debate on community water fluoridation

2013 12 23 15 23 25 385 Second Opinion 200

A recent broadcast on Public Radio International raised concerns about community water fluoridation without any mention of the hundreds of studies that have shown the benefits of fluoridation. reached out to the scientific and clinical community for their response to this broadcast. Our first response is from Deborah Foote, executive director of Oral Health Colorado.

On behalf of Oral Health Colorado, a network of Colorado organizations interested in improving oral health for all Coloradans, I write to express our coalition's overwhelming support of community water fluoridation and our continued dismay that mainstream media fails to recognize that there is no debate when it comes to community water fluoridation. Colorado is where researchers first discovered the benefits of fluoride in preventing dental caries, and we are proud of this legacy.

Deborah Foote is the executive director of Oral Health Colorado.Deborah Foote is the executive director of Oral Health Colorado.

In April, the U.S. Department of Health and Human Services (HHS) announced a final recommendation for the optimal fluoride level in drinking water to prevent tooth decay at 0.7 mg/L. Most U.S. cities and communities are already fluoridating their water at this level, and this new recommendation does not reflect a change in the evidence supporting the safety and effectiveness of this intervention.

Previously, it was understood that more fluoride was needed in some places and less in others, because research had shown that people consumed different amounts of water according to where they lived geographically (warm versus cool climates). With the advent of air conditioning, new research shows there is no longer a difference across the country in the consumption of water. Also, fluoride is now found in a variety of sources, including toothpaste, mouth rinse, professionally applied treatments, water, and processed foods. Both factors influenced the new recommendation. The optimal level is set to prevent tooth decay, while minimizing the incidence of dental fluorosis (a mild change in the appearance of the tooth's enamel). HHS now recommends one level for the entire nation.

“It is time that this false debate end, and we can put our energies toward solving the real problems facing our communities.”

One need to only look to the U.S. Public Health Service recommendation on fluoridation (July-August 2015) to see that there is no evidence that community water fluoridation causes a myriad of health issues. As the U.S. has been fluoridating water systems for 70 years, we have yet to see any evidence of these claimed ill health effects in communities that fluoridate their water. Hundreds of organizations, including the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Public Health Association, support community water fluoridation as a proven public health intervention.

Dental disease is the most common childhood disease and is associated with diabetes, adverse pregnancy outcomes, heart disease, and lost school and work hours. Fluoridated water decreases tooth decay by nearly 25% in children and adults, and it saves communities money by reducing costs and lost work hours spent on repairing tooth decay. For most cities, every $1 invested in water fluoridation saves $38 in unnecessary dental treatment costs, according to the CDC.

It is time that this false debate end, and we can put our energies toward solving the real problems facing our communities.

Deborah Foote is executive director of Oral Health Colorado, based in Lakewood.

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

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