The Continual Controversy on the Fluoridation of Communal Water Supplies
McIntyre, David M.
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The effects of fluoride in the public water source have been a topic of debate for many decades now. Many organizations like the American Dental Association and the World Health Organization support the benefits of water fluoridation for preventing dental caries (more commonly known as cavities) and oral health in general. The Centers for Disease Control and Prevention listed it as one of the ten greatest public health achievements in the 20th century. However, there has always been a strong opposition and has led many countries and communities to take action that prohibits fluoride to enter their water supplies. As this is a public health measure, it affects everyone in a community. In 2010, 74% of the United States population was served with fluoridated water supplies (Schneider, 2013). Further, those not living in these communities are exposed to fluoride via food products that are made with fluoridated water. The overwhelming presence of fluoride has caused some community members to seriously consider the costs and benefits, but often many others are unaware of this public health topic. To make a decision on communal water fluoridation, it is necessary to gain a full understanding of complex factors, including the history of water fluoridation throughout the world, the properties of fluorine as a chemical, how the body metabolizes it, how fluoride works to prevent tooth decay and dental caries, the cost effectiveness of water fluoridation, and alternative fluoride options. This paper offers a detailed explanation of divergent views on this topic, and the inherent ethical implications that arise when weighing the value of communal water fluoridation. The paper will also describe the history and evidence regarding the efficacy of water fluoridation and its mechanism of action. For the better part of a century, water fluoridation has withstood the countless attacks against it. As this paper has summarized, when fluoride concentrations range from 0.7-1.2 ppm in water supplies, there is no substantial evidence suggesting it has adverse health effects, and the balance between cost and benefits is in overwhelmingly in favor of taking this public health measure: today in the U.S., water fluoridation reduces tooth decay by up to 40%. Moreover, it is not only the “smart” choice; it is also the ethical choice to make. As a public health measure the government provides as a benefit to the population, water fluoridation focuses on children, equitably providing a resource for health to all children regardless of background. Furthermore, the economic benefits include the considerable savings for families who would otherwise incur costs for dental procedures that would likely occur if the child did not have the benefits of fluoride. It is important to remember that fluoride is a naturally occurring element in water, adjusted to optimal levels for populations to consumer. The available data suggest that fluoride at these concentrations provides maximum benefits to human health while minimizing the risks. As always, further research is needed to illuminate the dimensions of this issue; fluoride and its mechanisms of action occur on the microscopic level, and remain difficult to comprehend fully. Nevertheless, as the data summarized in this paper have shown, communities should feel confident that communal water fluoridation could provide significant benefits to residents without adverse health effects.