Policy Statement on Community Water Fluoridation

November 16, 2012

The Missouri Coalition for Oral Health Supports the

Expansion of Public Water System Fluoridation

Innovation and the responsible application of science to improve the public’s health have been hallmarks of American medicine. Eradicating small pox, eliminating polio and the fluoridation of drinking water are hailed as three of the greatest public health achievements of the 20th century by the Centers for Disease Control and Prevention (CDC)[1]. While tooth decay – an infectious disease – is highly preventable, it remains the single most common chronic childhood disease.[2] Untreated decay can lead to pain, illness, and even infection with the risk of death. A lack of prevention results in high dental costs for tooth fillings, extractions, and emergency room services. There is an even higher cost to society in missed school and work hours.

In spite of its prevalence and severity, we know how to prevent and control tooth decay. Scientific studies continue to show that widespread community water fluoridation (adjusting the fluoride concentration in the water supply to a level beneficial to reduce tooth decay and to promote good oral health) both prevents cavities and saves money. Fluoride is a naturally-occurring mineral that is found in local water supplies, at both sub-optimal as well as supra-optimal levels. In those communities where the public water supply has sub-optimal levels of fluoride, the mineral can be added as an easily-adjusted, safe, low-cost way of reducing the incidence and severity of tooth decay, improving oral and overall health. Our nation has over 65 years of experience in safely and effectively reducing decay through community water fluoridation.

Preventing tooth decay, a common oral disease, is fiscally responsible. The Surgeon General reported that nearly every American has experienced tooth decay. The United States has a population of over 310 million people. With a population this large, the cost savings of preventing tooth decay is huge. The American Dental Association reports that the cost over an entire lifetime of water fluoridation for an individual is less than the cost of a single dental filling. The CDC estimates that every $1 invested in this preventive measure yields approximately $38 savings in dental treatment costs.[3]

Fluoride’s proven effectiveness in reducing tooth decay has prompted many manufacturers to add fluoride to products such as toothpaste, mouth rinse, and some bottled waters, as fluoride helps not only to prevent demineralization but to remineralize tooth surfaces and prevent cavities from continuing to form. However, studies[KSL1] still show that water fluoridation reduces tooth decay by about 25% over a person’s lifetime.

Access to appropriate levels of fluoride is an effective, safe, and ideal public health measure. It benefits individuals of all ages and socioeconomic strata. Its preventive benefits are most cost-effective when delivered to all residents of a community through water fluoridation—that is, adjusting the fluoride in the public water supply to the appropriate level for decay prevention. Twenty-seven states have met the Healthy People 2010 objective of having 75% of their citizens on public water systems with water fluoridation.[4]However, over one third of the U.S. population is still without this effective public health measure. The most recent statistics available indicate that 1 out of 5 Missourians using public water systems do not receive fluoridated water. Unfortunately, Missouri has a recent trend of the elimination of community water fluoridation. In a short-sighted effort to reduce expenses, some Missouri communities have elected to discontinue fluoridation. This will inevitably lead to increases in tooth decay, and a reduction in oral health, along with higher costs to many individuals and families for treatment and care. It is a Healthy People 2020goal to increase the percentage of the population served by fluoridated public water systems.[5]

The Missouri Coalition for Oral Health, which represents community stakeholders, medical and dental providers, and policy makers, strongly supports community water fluoridation. Because it has the potential to reach the broadest spectrum of the population, fluoridation is the most practical way to prevent dental decay, and to reduce the incidence of dental infections associated with other systemic diseases. Public water fluoridation does not discriminate. It provides all members of a community with the ability to reduce dental disease. It is cost-effective, and provides people of all ages with protection from an infectious, painful disease process today, with the potential for them to continue as healthy, productive members of our communities tomorrow.

Please join the Missouri Coalition for Oral Health in making sure that Missouri communities can access the benefits of public water supply fluoridation.

[1] www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm

[2] www.aapd.org/media/ECCstats.pdf

[3] www.ada.org/sections/professionalResources/pdfs/flouoridation_facts.pdf

[4] www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm

[5] Oral Health Objective 13:http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=32