Water fluoridation

A public water supply system being adjusted for fluoride concentration.

Water fluoridation is the controlled addition of fluoride to a public water supply to prevent dental caries (tooth decay). By maintaining the fluoride concentration at about one part per million (1 ppm), water fluoridation aims to minimize the occurrence of dental caries while reducing the risk of dental fluorosis, which can occur with excessive fluoride exposure.

Overview

Water fluoridation adjusts the natural concentration of fluoride ion in water to a level that is effective for reducing tooth decay. This public health intervention is recognized for its role in improving dental health across populations, irrespective of age or socio-economic status.

History

The practice began in Grand Rapids, Michigan, in 1945, marking the start of the first community water fluoridation scheme. Following its success, numerous studies in various countries have demonstrated the benefits of fluoridated water in reducing the prevalence of dental caries.

Benefits

• Caries Reduction: Studies have shown a 50–60% reduction in caries in permanent teeth and a 40–50% reduction in deciduous (baby) teeth among populations using fluoridated water.
• Cost-Effectiveness: Fluoridation is considered the least expensive method of fluoride delivery, benefiting large groups of people across different ages.
• Surface Protection: Approximately 90% of the benefits are observed on smooth surfaces of teeth, with a 35% effectiveness on occlusal (biting) surfaces.

Mechanism

Fluoride works by enhancing the remineralization of teeth, making them more resistant to acid attacks from bacteria in the mouth. It also inhibits the ability of these bacteria to produce acid.

Implementation

The process involves the careful monitoring and adjustment of fluoride levels in water treatment facilities to ensure the concentration remains at the optimal level for dental health.

Controversies and Safety

While water fluoridation is endorsed by major health organizations worldwide, it has faced opposition based on ethical, legal, and safety concerns. The key to safe fluoridation is maintaining fluoride at levels that balance benefits and risks.

Important Studies on Water Fluoridation

Important Studies on Water Fluoridation

Experiment city	Control city	Time of fluoridation	Caries reduction
Grand-Rapids in Michigan	Muskegon	6 ½ years	Half that in Muskegon
Newburg in New York	Kingston	10 years	23.5% dropped to 13.9%
Evanston in Illinois	Oak park	17 years	55%
Brantford in Ontario	Sarnia	14 years	49%
Tiel in Netherlands	Culemborg	13 years	58%

Planning a Water Fluoridation Program

Collect baseline information

• To find out the number of people in the city.
• The water source used by them.
• Analyze the water to estimate the fluoride concentration.
• Find out whether there is centralized water facility.

Permission

• To be obtained from the higher authority.
• Governmental clearance.

Resources

• Funds for installation, maintenance, monitoring of water fluoridation plant and other expenses.
• Location: Place for installing the water fluoridation plant.
• Personnel: Intersectoral co-ordination between the government, community leaders, doctors, health authorities, engineer, scientific workers, nutritionist, public health personnel, grass root level worker.

Type of method to be used and the chemical used

• Different types of equipment's for water fluoridation:

1. Saturator system
2. Dry feeder system
3. Solution feeder system

• The different fluoride compounds which can be used in water fluoridation:

1. Fluorspar
2. Sodium fluoride (expensive)
3. Silico-fluorides
4. Sodium silico- fluorides(economical)
5. Hydrofluorosilic acid

Estimation of the quantity of fluoride to be added to the water

• (Depends on the climatic condition) The empiric formula for estimating the fluoride in water is given by Galagon and Vermillion in 1957.

ppm fluoride = 0.34/E

Where E= – 0.038 + 0.0062 × Temperature of the area in Fahrenheit

Evaluation

• Continuous monitoring of the quality of water, fluoride level and safety of health.
• Continuous monitoring of the working conditions and the technical aspects.

Practical Aspects of Water Fluoridation

• There should be presence of centralized water supply.
• People should not drink water from other sources like wells or tanks.
• Suitable equipment and continuous supply of chemical should be assured.
• Sufficient money should be available for initial installation and running cost.

See Also

• Dental caries
• Dental fluorosis
• Public health

References

• Placeholder for references. Use the format:
• Additional references and studies on water fluoridation's impact and implementation.

External Links

• [Placeholder for link to CDC's page on water fluoridation]
• [Placeholder for link to WHO guidelines on fluoride intake]

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