What do your patients know about fluoridation?

Molly Melbye, D.D.S., MPH
Research fellow, University of Washington School of Dentistry

Priscilla Lewis, RN, MBA
Executive director, Providence Community Services and Development
Providence Community Health Division

April 17, 2013

Portland is the only major U.S. city that doesn’t add fluoride to its water supply. Yet despite the public health benefits, misinformation about fluoridation persists.

Physicians are compelled to be informed on what causes tooth decay and how to prevent it, and to deliver accurate, scientifically sound information to their patients. Fortunately, the evidence is vast (spanning six decades) and rigorous. It has been heavily scrutinized by reputable health and science organizations, including the Centers for Disease Control and Prevention.

Caries, the entirely preventable disease that causes tooth decay, is the most common childhood disease, affecting five times more children than asthma. Tooth decay causes severe pain and suffering among children and impacts their school attendance and success, development and general health.

Oregon Smile Survey 2007 found that among 32 states reporting, Oregon ranked seventh for the percentage of school children with untreated decay. On any given day, more than 5,000 children in Oregon are in school and suffering from dental pain or infection, many of whom are poor.

Tooth decay is caused by myriad factors which are not easily changed in individuals, including a high-sugar diet and poor oral hygiene. However, the effects of these factors can be lessened or reversed by drinking fluoridated water. Many children and vulnerable adults do not have access to toothpaste or regular dental care, so adding fluoride to drinking water is a key preventive measure for these populations.

In the 1940s, a Colorado dentist discovered that the reason he saw so little tooth decay in his patients was because the community’s water supply had a higher concentration of fluoride. Many fresh and ocean waters in and around the United States are naturally fluoridated by rocks and soil, ranging in concentration from about 0.1 to more than 12 parts per million. Since then, the CDC has determined that adding 0.7 to 1.2 ppm of fluoride to the water supply safely reduces tooth decay by as much as 60 percent in children and nearly 35 percent in adults.

Like many other preventive interventions, water fluoridation is also cost-effective. The CDC estimates that every $1 invested in community water fluoridation saves $38 in dental treatment costs while improving the oral health of everyone in the community.

Community water fluoridation makes a positive difference in the oral health, especially among vulnerable children and adults. Please take action by understanding the facts about fluoride and supporting community water fluoridation as a public health intervention.