COMMUNITY WATER FLUORIDATION
In 1945, Grand Rapids, Mich., became the first city in America to add fluoride to its water supply to reduce tooth decay. This began a steady increase in community water fluoridation as a low-cost, efficient public health intervention. Fluoride occurs naturally in water at varying levels. Adding or reducing fluoride in the water to about 1 part per million has been found to reduce tooth decay substantially at a low cost of less than $1 dollar per person per year, depending on the size of the community. Although fluoride is particularly beneficial to children while their teeth are forming, it helps throughout life. It is superior to other options because no individual or family decision has to be made to benefit and no appointment or routine compliance or purchase of a product is necessary. In 1999, the Centers for Disease Control included water fluoridation in its list of 10 great public health achievements of the 20th century. As of 2002, 162 million people drink fluoridated water. This represents 66 percent of the 245 million who are served by public water supplies.
About 27 states have achieved the goal established by the Department of Health and Human Services of fluoridating water for 75 percent or more of their citizens. Although public water systems are managed locally, state legislatures become involved with fluoridation when they appropriate funds for oral health programs, assist communities with fluoridation, or consider legislation that mandates or prohibits water fluoridation. According the Centers for Disease Control (CDC), 11 states- California, Connecticut, Delaware, Georgia, Illinois, Kentucky, Minnesota, Nebraska, Nevada, Ohio and South Dakota-plus Puerto Rico and the District of Columbia currently mandate community water fluoridation.
Community water fluoridation has its opponents. A variety of groups, such as the Fluoride Action Network, Citizens for Safe Drinking Water and the Citizens for Health, oppose fluoridation because they claim it has never been tested for safety; it leads to a high incidence of fluorosis, (discoloring of tooth enamel) and causes bone fractures, cancer, osteoporosis, arthritis, kidney disorders, low sperm count, low IQ and other problems. The Foundation for Neuroscience and Safety links community water fluoridation to higher rates of lead poisoning in children, which causes hyperactivity, learning disabilities, substance abuse and violent crime. Some people also feel that adding fluoride should be a personal choice and that adding it to the water is "mass medication."
Senator Ray Rawson, a Nevada dentist who led the drive for fluoridating water in Las Vegas, calls these arguments "junk science." "Fluoride really works, and it really is safe," he says. More than 3,700 studies on fluoride have been completed during the last 30 years, including 50 peer-reviewed epidemiological studies, and none has established a higher risk of cancer or any other disease. A review of the scientific literature shows only a few studies that document health problems in animals, and then only when subjects were given concentrations of fluoride that are 50 to 200 times higher than people could possibly obtain through drinking fluoridated water. In 1978, Consumer Reports magazine wrote "The simple truth is that there is no scientific controversy over the safety of fluoridation. The practice is safe, economical and beneficial." Opposition to community water fluoridation has slowed progress in getting communities on board, which has led to higher rates of tooth decay and health care costs.
For legislators who are interested in alternatives to fluoridated water, other options exist which most states pursue, primarily for rural and frontier communities who use well water. In 2001, 34 state oral health programs provided school-based programs that provide fluoride mouth rinses or tablets to 1.1 million children. Fourteen states have programs to apply dental sealants-which coat permanent teeth to prevent tooth decay- among high-risk populations. Fewer than 150,000 children were helped this way in 2001. These programs are more expensive than community water fluoridation, and reach relatively few people.
TO NEXT SECTION (IN THE ABSTRACT)
BACK TO MAIN
|
