Holly‌‌Milby‌ 

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Community‌‌Health‌‌Concepts‌  ‌
Public‌‌Health‌‌Research‌‌Abstract‌‌Paper‌  ‌
August‌‌9th‌‌2021‌  ‌
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Water‌‌Fluoridation‌  ‌

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According‌‌to‌‌the‌‌CDC,‌‌water‌‌fluoridation‌‌is‌‌among‌‌the‌‌top‌‌10‌‌great‌‌health‌‌achievements‌‌ 

for‌‌the‌‌20th‌‌century.‌‌Understanding‌‌the‌‌benefits‌‌to‌‌fluoride‌‌and‌‌knowing‌‌the‌‌research‌‌behind‌‌it‌‌ 

can‌‌greatly‌‌benefit‌‌your‌‌patients‌‌who‌‌are‌‌unaware‌‌of‌‌the‌‌benefits‌‌it‌‌produces.‌‌The‌‌American‌‌
 

Dental‌‌Association‌‌as‌‌well‌‌as‌‌the‌‌National‌‌Institutes‌‌of‌‌Health‌‌have‌‌released‌‌articles‌‌discussing‌‌
 

the‌‌research‌‌and‌‌benefits‌‌behind‌‌fluoride‌‌as‌‌well‌‌as‌‌the‌‌statistics‌‌behind‌‌it.‌‌   ‌

Understanding‌‌what‌‌fluoride‌‌is‌‌in‌‌itself‌‌is‌‌a‌‌huge‌‌beginning‌‌step‌‌to‌‌understanding‌‌the‌‌ 

benefits‌‌of‌‌it.‌‌Fluoride‌‌is‌‌the‌‌13th‌‌most‌‌abundant‌‌element‌‌in‌‌the‌‌earth,‌‌meaning‌‌that‌‌it‌‌is‌‌naturally‌‌ 

produced.‌‌Back‌‌in‌‌1945,‌‌Grand‌‌Rapids‌‌Michigan‌‌was‌‌the‌‌first‌‌to‌‌use‌‌fluoride‌‌in‌‌drinking‌‌water,‌‌ 

at‌‌1‌‌ppm.‌‌By‌‌adding‌‌fluoride‌‌to‌‌water,‌‌dental‌‌decay‌‌was‌‌reduced‌‌by‌‌70%.‌‌Obviously‌‌preventing‌‌
 

dental‌‌decay‌‌in‌‌the‌‌community‌‌was‌‌a‌‌big‌‌benefit,‌‌but‌‌the‌‌great‌‌thing‌‌is‌‌that‌‌fluoride‌‌is‌‌very‌‌cost‌‌
 

effective‌‌as‌‌well.‌‌The‌‌cost‌‌per‌‌person‌‌for‌‌an‌‌entire‌‌year‌‌of‌‌fluoride‌‌is‌‌a‌‌mere‌‌73‌‌cents.‌‌According‌‌ 

to‌‌the‌‌ADA,‌‌“Studies‌‌prove‌‌water‌‌fluoridation‌‌continues‌‌to‌‌be‌‌effective‌‌in‌‌reducing‌‌tooth‌‌decay‌‌
 

by‌‌more‌‌than‌‌25%‌‌in‌‌children‌‌and‌‌adults,‌‌even‌‌in‌‌an‌‌era‌‌with‌‌widespread‌‌availability‌‌of‌‌fluoride‌‌
 

from‌‌other‌‌sources,‌‌such‌‌as‌‌fluoride‌‌toothpaste”.‌‌Not‌‌only‌‌has‌‌fluoridated‌‌water‌‌been‌‌beneficial,‌‌
 

but‌‌we‌‌can‌‌also‌‌find‌‌fluoride‌‌in‌‌other‌‌sources‌‌such‌‌as‌‌fish‌‌and‌‌tea.‌  ‌

Clearly‌‌there‌‌is‌‌a‌‌big‌‌benefit‌‌not‌‌only‌‌financially‌‌by‌‌saving‌‌patients‌‌money‌‌on‌‌restorative‌‌ 

work‌‌at‌‌a‌‌small‌‌cost‌‌to‌‌the‌‌community,‌‌but‌‌also‌‌there‌‌is‌‌the‌‌benefit‌‌of‌‌preventing‌‌the‌‌disease‌‌of‌‌
 

dental‌‌decay.‌‌Determining‌‌the‌‌correct‌‌amount‌‌and‌‌frequency‌‌of‌‌fluoride‌‌is‌‌something‌‌that‌‌took‌‌a ‌‌

while‌‌and‌‌is‌‌still‌‌being‌‌altered‌‌to‌‌this‌‌day.‌‌Currently‌‌the‌‌amount‌‌of‌‌fluoride‌‌in‌‌community‌‌
 
drinking‌‌water‌‌is‌‌set‌‌at‌‌.7‌‌ppm‌‌which‌‌is‌‌monitored‌‌by‌‌the‌‌Environmental‌‌Protection‌‌Agency.‌‌ 

Also‌‌according‌‌to‌‌the‌‌ADA,‌‌“Community‌‌water‌‌fluoridation‌‌is‌‌the‌‌controlled‌‌adjustment‌‌of‌‌ 

fluoride‌‌that‌‌occurs‌‌naturally‌‌in‌‌all‌‌water‌‌to‌‌optimal‌‌levels‌‌to‌‌prevent‌‌tooth‌‌decay.‌‌In‌‌2013,‌‌using‌‌ 

an‌‌updated‌‌systematic‌‌review,‌‌the‌‌Community‌‌Preventive‌‌Services‌‌Task‌‌Force,‌‌established‌‌by‌‌the‌‌
 

U.S.‌‌Department‌‌of‌‌Health‌‌and‌‌Human‌‌Services,‌‌continued‌‌to‌‌recommend‌‌community‌‌water‌‌
 

fluoridation‌‌to‌‌reduce‌‌tooth‌‌decay,‌‌noting‌‌that‌‌cavities‌‌decreased‌‌when‌‌fluoridation‌‌was‌‌
 

implemented‌‌and‌‌that‌‌cavities‌‌increased‌‌when‌‌fluoridation‌‌was‌‌stopped,‌‌as‌‌compared‌‌to‌‌
 

communities‌‌that‌‌continued‌‌fluoridation.34‌‌This‌‌confirmed‌‌the‌‌Task‌‌Force’s‌‌earlier‌‌systematic‌‌
 

review‌‌published‌‌in‌‌200245‌‌which‌‌also‌‌noted‌‌an‌‌increase‌‌in‌‌tooth‌‌decay‌‌when‌‌fluoridation‌‌was‌‌
 

halted‌‌(a‌‌median‌‌17.9%‌‌increase‌‌in‌‌tooth‌‌decay‌‌during‌‌6‌‌to‌‌10‌‌years‌‌of‌‌follow-up)”.‌  ‌

So‌‌if‌‌fluoride‌‌is‌‌so‌‌beneficial,‌‌why‌‌is‌‌it‌‌a‌‌controversial‌‌topic?‌‌Oftentimes‌‌toxicity‌‌only‌‌
 

occurs‌‌when‌‌fluoride‌‌is‌‌used‌‌incorrectly/inappropriately‌‌and‌‌a‌‌lack‌‌of‌‌knowledge‌‌is‌‌present.‌‌
 

Some‌‌argue‌‌that‌‌there‌‌are‌‌no‌‌deficiencies‌‌from‌‌a‌‌lack‌‌of‌‌fluoride‌‌so‌‌why‌‌add‌‌it‌‌into‌‌the‌‌diet.‌‌ 

According‌‌to‌‌the‌‌ADA,‌‌“water‌‌that‌‌has‌‌been‌‌fortified‌‌with‌‌fluoride‌‌is‌‌similar‌‌to‌‌fortifying‌‌salt‌‌ 

with‌‌iodine,‌‌milk‌‌with‌‌vitamin‌‌D‌‌and‌‌orange‌‌juice‌‌with‌‌vitamin‌‌C‌‌—‌‌none‌‌of‌‌which‌‌are‌‌
 

medications”.‌‌Another‌‌argument‌‌is‌‌that‌‌dental‌‌fluorosis‌‌is‌‌a‌‌common‌‌side‌‌effect‌‌and‌‌that‌‌it‌‌can‌‌ 

cause‌‌disorders‌‌and‌‌diseases‌‌such‌‌as‌‌hypothyroidism.‌‌In‌‌rebuttal,‌‌reputable‌‌sources‌‌have‌‌stated‌‌ 

that‌‌the‌‌fluoride‌‌in‌‌water‌‌is‌‌constantly‌‌monitored‌‌by‌‌the‌‌EPA‌‌and‌‌fluorosis‌‌is‌‌more‌‌common‌‌from‌‌ 

inappropriate‌‌fluoride‌‌supplementation,‌‌which‌‌can‌‌easily‌‌be‌‌eliminated.‌‌   ‌

In‌‌conclusion,‌‌water‌‌fluoridation‌‌is‌‌greatly‌‌benefiting‌‌the‌‌community‌‌and‌‌not‌‌only‌‌those‌‌ 

young‌‌in‌‌age,‌‌but‌‌all‌‌the‌‌way‌‌through‌‌a‌‌geriatric‌‌age.‌‌According‌‌to‌‌the‌‌ADA,‌‌“For‌‌more‌‌than‌‌65‌‌
 

years,‌‌the‌‌best‌‌available‌‌scientific‌‌evidence‌‌consistently‌‌indicates‌‌that‌‌community‌‌water‌‌
 

fluoridation‌‌is‌‌safe‌‌and‌‌effective”.‌   ‌ ‌
Sources:‌  ‌
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http://www.ada.org/~/media/ADA/Files/Fluoridation_Facts.pdf?la=en‌  ‌
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956646/‌  ‌
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http://www.ada.org/~/media/ada/member%20center/files/article_10reasons.ashx‌  ‌
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