Monday, February 27, 2012

Fluoridated Water and Dentistry: The Ongoing Debate

This map shows the percentage of state populations served by community water systems with optimally fluoridated water.Source: CDC, July 11, 2008

Medscape Today has a great post up about fluoridated water - the good, the bad and the ugly.

Along with vaccination, control of infectious diseases, and motor vehicle safety, adding fluoride to US drinking water is considered one of the greatest public health achievements of the 20th century.[1] Fluoride was first added to water in 1945, a measure that was followed by a dramatic 50%-70% decline in the incidence of decayed, missing, or filled teeth (DMFT) in the United States.[2] Fluoridation was considered a safe and inexpensive way to prevent tooth decay, regardless of socioeconomic status or access to dental care.

The success of supplemental fluoride in reducing tooth decay and loss led to a search for additional modalities for delivery of fluoride, such as toothpastes, gels, mouth rinses, tablets, drops, and professionally applied fluoride treatments.[2] More than 65 years after fluoride was first added to community water supplies, the outcome of the "more is better" approach is an inability to accurately quantify the population's exposure to fluoride. Is it enough? Is it too much?

One year ago, after extensive review of the available evidence, the US Department of Health and Human Services (HHS) and the US Environmental Protection Agency (EPA) recommended that the maximum level of fluoride in drinking water be lowered to 0.7 mg/L (currently the minimum of the optimal range, 0.7-1.2 mg/L).[3] This step was taken to balance the benefits of supporting dental health in all children by preventing dental caries while limiting the risk for inducing fluorosis because of the unknown, and possibly excessive, exposure to fluoride from multiple combined sources.[4] Still, the practice of adding any fluoride at all to municipal water supplies has vocal opponents.

Read all of the post.

Should we continue water fluroidation?

Or, should be revert back to the 1950's when, believe it or not, children's dental health was even worse than today?

I'll go with continued fluoridation, monitoring and more study.

In my dental carer, I have seen too much pain and suffering from dental caries, to go back to the good ol' days.

But, what do you think?

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