|
Statement on Water Fluoridation
Community water fluoridation is a public health effort that benefits
millions of Americans. For more than half a century, water
fluoridation has helped improve the quality of life in the U.S.
through reduced pain and suffering related to tooth decay, reduced
tooth loss, reduced time lost from school and work, and less money
spent on dental care.
The National Institute of Dental and Craniofacial Research continues
to support water fluoridation as a safe and effective method of
preventing tooth decay in people of all ages. one significant
advantage of water fluoridation is that anyone, regardless of
socioeconomic level, can enjoy its benefits during their daily lives
-- at work, school, and play -- simply by drinking fluoridated water
or beverages prepared with fluoridated water. Within the U.S.,
fluoridated drinking water is also the most cost-effective method for
preventing tooth decay.
Efficacy. The effectiveness of water fluoridation has been well
documented in the scientific literature. Even before the first
community fluoridation program began in 1945, epidemiologic data from
the 1930s and 1940s revealed a lower prevalence of tooth decay in
children who consumed naturally occurring fluoridated water, compared
to children who had consumed fluoride-deficient water. Since that
time, numerous studies have proven fluoride's effectiveness in decay
prevention in the primary teeth of infants and children, as well as in
the permanent teeth of children, adolescents and adults, including
senior citizens.
Safety. As with other nutrients, fluoride is safe and effective when
used and consumed properly. After more than 50 years of research and
practical experience -- as well as data evaluation by the U.S.
government, committees of experts, and national and international
health organizations -- the verdict remains the same: fluoridating
community water supplies, at optimal levels, is an effective and safe
method for preventing tooth decay. Moreover, no credible scientific
evidence supports an association between fluoridated water and
conditions such as cancer, bone fracture, Down's syndrome, or heart
disease as claimed by some opponents of water fluoridation.
Cost-effectiveness.Community water fluoridation is presently the most
cost-effective method for preventing tooth decay. on average, it
costs less than $1 annually per person to fluoridate community water
systems serving most people in this country. The costs range from an
average of 68 cents per person annually in communities with
populations larger than 50,000, to an average of $3.00 per person
annually in communities of fewer than 10,000 (1999 dollars).
Equity. Despite a decrease in overall decay rates during the past two
decades, tooth decay is still a significant oral health problem,
especially in certain segments of the population. People of low
socioeconomic status suffer from a disproportionate burden of tooth
decay. They also have less access than those with higher incomes to
professional oral health services and other sources of fluoride, like
gels and tablets. Water fluoridation helps reduce such oral health
disparities.
|
As
noted in Oral Health in America: A Report of the Surgeon General,
community water fluoridation continues to be the most
cost-effective, equitable and safe means to provide protection
from tooth decay in a community. Scientific studies have found
that people living in communities with fluoridated water have
fewer cavities than those living where the water is not
fluoridated. For more than 50 years, small amounts of fluoride
have been added to drinking water supplies in the United States
where naturally-occurring fluoride levels are too low to protect
teeth from decay. Over 8,000 communities are currently adjusting
the fluoride in their community’s water to a level that can
protect the oral health of their citizens.
Over 170 million people, or 67 percent of the United States
population served by public water supplies, drink water with
optimal fluoride levels for preventing decay. Of the 50 largest
cities in the country, 43 are fluoridated. Although water
fluoridation reaches some residents in every state, unfortunately,
only 24 states are providing these benefits to 75 percent or more
of their residents.
A significant advantage of water fluoridation is that all
residents of a community can enjoy its protective benefit—at home,
work, school, or play—simply by drinking fluoridated water or
beverages and foods prepared with it. A person’s income level or
ability to receive routine dental care is not a barrier to
receiving fluoridation’s health benefits. Water fluoridation is a
powerful strategy in our efforts to eliminate differences in
health among people and is consistent with my emphasis on the
importance of prevention.
The U.S. Centers for Disease Control and Prevention has recognized
the fluoridation of drinking water as one of ten great public
health achievements of the twentieth century. Water fluoridation
has helped improve the quality of life in the United States by
reducing pain and suffering related to tooth decay, time lost from
school and work, and money spent to restore, remove, or replace
decayed teeth. An economic analysis has determined that in most
communities, every $1 invested in fluoridation saves $38 or more
in treatment costs. Fluoridation is the single most effective
public health measure to prevent tooth decay and improve oral
health over a lifetime, for both children and adults.
While we can be pleased with what has already been accomplished,
it is clear that there is much yet to be done. Policymakers,
community leaders, private industry, health professionals, the
media, and the public should affirm that oral health is essential
to general health and well being and take action to make
ourselves, our families, and our communities healthier. I join
previous Surgeons General in acknowledging the continuing public
health role for community water fluoridation in enhancing the oral
health of all Americans.
Richard H. Carmona, M.D., M.P.H., F.A.C.S.
VADM, USPHS
United States Surgeon General |
|
