Fluoridation Promise

According to the Virginia Department of Health’s Web site:
“Over 50 years of scientific studies conclude:
Water fluoridation reduces tooth decay 20 to 40 Percent.”

Unspoken Reality
Washington DC, fluoridated since 1952, has “one of the highest decay rates in children in
the country.” Washington Post, March 5, 2002

New York City, fluoridated since 1965, has more children that required cavity-related
hospitalizations, proportionately, than two of New York State’s largest non-fluoridated counties.
Journal of Public Health Dentistry, Winter 2003

Boston, fluoridated since 1978:

“With a study estimating that the number of untreated cavities
among Boston students greatly exceeds the national average, public health officials are about to launch an
offensive against what they say is a growing dental crisis in the city.” Boston Globe, November 27, 1999.

Cincinnati, fluoridated since 1979:

City and regional medical officials say tooth decay is the
city's No. 1 unmet health-care need. “We cannot meet the demand,” says Dr. Larry Hill, Cincinnati
Health Department dental director. “It's absolutely heartbreaking and a travesty. We have kids in this
community with severe untreated dental infections. We have kids with self-esteem problems, and we have
kids in severe pain and we have no place to send them in Cincinnati. People would be shocked to learn
how bad the problem has become.” The Cincinnati Enquirer October 6, 2002
Cincinnati: http://www.enquirer.com/editions/2002/10/06/loc_special_report.html

Pittsburgh, fluoridated since 1952, reports that nearly half of the children between 6 and 8
have had cavities. More than 70 percent of 15-year-olds in the city have had cavities, the highest
percentage in the state. Close to 30 percent of the city’s children have untreated cavities.
Tribune-Review, Sunday, February 13, 2005.

Augusta, Georgia, fluoridated “years and years ago," had 80.9% of the 12-14 year old
children living in Augusta exhibit dental fluorosis. “Moderate-to-severe fluorosis was found in 14% of
the children…caries prevalence was observed to increase when fluoride concentrations were such that
severe dental fluorosis was common and the enamel of affected individuals was friable and liable to
fracture…fluorosis was twice as prevalent among African-American children than white children”
Health Effects of Ingested Fluoride, 1993, National Research Council, Pages 37, 44, 45.

The New York Times, March 6, 2012. Rise in Preschool Cavities Prompts Anesthesia
Use. Reports of dental crisis in fluoridated Seattle, Augusta, Me., Manhattan, Brooklyn, Columbus,
Philadelphia and Boston.

Fluoride News Tracker Blog. Covers escalating dental woes in spite of fluoridation.

Dental caries experience in northern Manhattan
J Public Health Dent. 2003 Summer;63(3):189-94.
Mitchell DA, Ahluwalia KP, Albert DA, Zabos GP, Findley SE, Trinh-Shevrin CB, Marshall SE, Lamster
IB, Formicola AJ.

Columbia University School of Dental and Oral Surgery, Division of Community Health, 630 West 168th
Street, P&S Box 20, New York, NY 10032, USA. dml48@columbia.edu


The study sought to document dental caries among adolescents residing in northern Manhattan, New
York, by race, sex, and community.

Clinical and demographic data were collected from children aged 12-17 years at five school-based dental
clinics in northern Manhattan. Data on dental caries were collected by calibrated examiners using the
National Institute of Dental and Craniofacial Research criteria for oral examinations.

A total of 566 children participated in the study. They were predominantly Hispanic (64%) or African
American (28%). Compared to data from the National Health and Nutrition Examination Survey III, mean
DMFT (3.36 vs 2.53; P<.01) and the prevalence of untreated disease (36% vs 16%; P<.01) were
significantly higher for northern Manhattan adolescents. Of the adolescents evaluated, 13 percent had at
least one severely carious tooth with pulpal involvement that required either extraction or endodontic

Adolescents in northern Manhattan have higher caries prevalence and higher levels of untreated caries
than their national counterparts. Carious lesions progress to pulpal involvement in a high percentage of
northern Manhattan children and require extraction or root canal therapy as treatment. There is an urgent
need for affordable and available dental primary care services targeted to economically disadvantaged
[PubMed - indexed for MEDLINE]

The oral health status of adolescents in northern
J Health Care Poor Underserved. 2007 Nov;18(4):814-32.
Mitchell DA, Borrell LN, Lassiter SL, Formicola AJ.

Harlem Hositpal Center Department of Dentistry, NY, USA. DML48@columbia.edu

Objectives. This study was designed to describe the oral health status of adolescents residing in northern
Manhattan. Methods. Clinical, demographic, and behavioral data were collected from 3,282 youths who
ranged in age from 12 to 16 years. Clinical examinations were performed by two trained examiners.
Demographic and behavioral data were self-reported. Results. The adolescents were predominantly
Hispanic/Latino and Black/African American (94%), with 6% falling into other racial categories. Caries
were discovered in a significant proportion of these youths (52% of Hispanics, 54% of Blacks and 54% of
others). Despite similar caries experiences, the oral health disease burden was not evenly distributed
across groups. In many cases, Hispanic youths demonstrated less disease and more frequent engagement
in oral health promoting behaviors than their non-Hispanic peers. Gender differences were less consistent.
Conclusions. Economically disadvantaged and minority youths, such as those residing in northern
Manhattan, continue to be unduly burdened by untreated dental disease. Further, our data suggest that
certain subpopulations may be particularly vulnerable to dental disease. This vulnerability underscores the
need for accessible services addressing the oral health needs of these segments of the population. Finally,
effective community-based oral disease prevention and health promotion programs are sorely needed to
improve these youths' oral health.
[PubMed - indexed for MEDLINE]

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