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Centers for Disease Control and Prevention. [31] Some studies suggest that fluoridation reduces oral health inequalities between the rich and poor, but the evidence is limited. A person living in an area with fluoridated water may experience rises of fluoride concentration in saliva to about 0.04 mg/L several times during a day. Issues studied have included fluoride concentrations in groundwater and downstream rivers; lawns, gardens, and plants; consumption of plants grown in fluoridated water; air emissions; and equipment noise. Community water fluoridation is the process of adjusting the amount of fluoride in drinking water to a level recommended for preventing tooth decay. Dean and his colleagues assumed that fluoride's protection against cavities was also pre-eruptive, and this incorrect assumption was accepted for years. [86][87], The history of water fluoridation can be divided into three periods. This approach is therefore not accepted in most countries in the world. [52] A 2011 European Commission review found that the benefits of water fluoridation for adult in terms of reductions in decay are limited. [55] The 2015 Cochrane review estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12%. [7], Tooth decay remains a major public health concern in most industrialized countries, affecting 60–90% of schoolchildren and the vast majority of adults. [34], In the first half of the 19th century, investigators established that fluoride occurs with varying concentrations in teeth, bone, and drinking water. The Australian government review states that water fluoridation is the most effective means of achieving fluoride exposure that is community-wide. In the second half they speculated that fluoride would protect against tooth decay, proposed supplementing the diet with fluoride, and observed mottled enamel (now called severe dental fluorosis) without knowing the cause. It can be accomplished by percolating water through granular beds of activated alumina, bone meal, bone char, or tricalcium phosphate; by coagulation with alum; or by precipitation with lime. [71], Fluoride's effects depend on the total daily intake of fluoride from all sources. [15] Dental sealants are effective as well,[24] with estimates of prevented cavities ranging from 33% to 86%, depending on age of sealant and type of study. The third period, from 1945 on, focused on adding fluoride to community water supplies. January 25, 2020, marked the 75th anniversary of intentional water fluoridation in the United States (US). Achievements in public health, 1900-1999: fluoridation of drinking water to prevent dental caries", "One in a million: the first community trial of water fluoridation", "Studies on mass control of dental caries through fluoridation of the public water supply", "Collaboration, vision and reality: water fluoridation in New Zealand (1952-1968)", "Salt fluoridation--an alternative in automatic prevention of dental caries", "Economic Evaluation of Community Water Fluoridation: A Community Guide Systematic Review", "Equilibrium effects of public goods: the impact of community water fluoridation on dentists", "When public action undermines public health: a critical examination of antifluoridationist literature", "A critique of recent economic evaluations of community water fluoridation", "The science and ethics of water fluoridation", https://en.wikipedia.org/w/index.php?title=Water_fluoridation&oldid=990914830, Wikipedia indefinitely semi-protected pages, Creative Commons Attribution-ShareAlike License, This page was last edited on 27 November 2020, at 06:34. [94], In the 1930s and early 1940s, H. Trendley Dean and colleagues at the newly created U.S. National Institutes of Health published several epidemiological studies suggesting that a fluoride concentration of about 1 mg/L was associated with substantially fewer cavities in temperate climates, and that it increased fluorosis but only to a level that was of no medical or aesthetic concern. [14] About 70–90% of ingested fluoride is absorbed into the blood, where it distributes throughout the body. [2] In affluent countries the cost of salt fluoridation is also negligible; developing countries may find it prohibitively expensive to import the fluoride additive. [30], The goal of water fluoridation is to prevent a chronic disease whose burdens particularly fall on children and the poor. In 2004, an estimated 13.7 million people in western Europe and 194 million in the U.S. received artificially fluoridated water. Communities served by fluoridated water save an average of $32 per person a year by avoiding treatment for cavities. [41], Although fluoride was once considered an essential nutrient, the U.S. National Research Council has since removed this designation due to the lack of studies showing it is essential for human growth, though still considering fluoride a "beneficial element" due to its positive impact on oral health. At least six Central European countries (Hungary, the Czech and Slovak Republics, Croatia, Slovenia, Romania) have shown some interest in salt fluoridation; however, significant usage of approximately 35% was only achieved in the Czech Republic. Here, aesthetic concern is a term used in a standardized scale based on what adolescents would find unacceptable, as measured by a 1996 study of British 14-year-olds. [17] It has been introduced to varying degrees in many countries and territories outside the U.S., including Argentina, Australia, Brazil, Canada, Chile, Colombia, Hong Kong, Ireland, Israel, Korea, Malaysia, New Zealand, the Philippines, Serbia, Singapore, Spain, the UK, and Vietnam. [5] In 2011 the World Health Organization suggested a level of fluoride from 0.5 to 1.5 mg/L (milligrams per litre), depending on climate, local environment, and other sources of fluoride. Achievements in public health, 1900-1999: fluoridation of drinking water to prevent dental caries. McKay spent thirty years investigating the cause of what was then known as the Colorado brown stain, which produced mottled but also cavity-free teeth; with the help of G.V. After the sugar is gone, some of the mineral loss can be recovered—or remineralized—from ions dissolved in the saliva. This, also, stabilizes naturally soft water so corrosion can be minimized in the water distribution system and plumbing of customers. [31] The effectiveness of water fluoridation can vary according to circumstances such as whether preventive dental care is free to all children. [46], These standards are not appropriate for all parts of the world, where fluoride levels might be excessive and fluoride should be removed from water, and is based on assumptions that have become obsolete with the rise of air conditioning and increased use of soft drinks, processed food, fluoridated toothpaste, and other sources of fluorides. More than 75 years of research and experience shows that community water fluoridation is a safe and healthy practice. [35] A 1992 census found that, for U.S. public water supply systems reporting the type of compound used, 63% of the population received water fluoridated with fluorosilicic acid, 28% with sodium fluorosilicate, and 9% with sodium fluoride. [12] There is no clear evidence of other adverse effects from water fluoridation. Fluorosis can be prevented by monitoring all sources of fluoride, with fluoridated water directly or indirectly responsible for an estimated 40% of risk and other sources, notably toothpaste, responsible for the remaining 60%. [11] Recent studies suggest that water fluoridation, particularly in industrialized nations, may be unnecessary because topical fluorides (such as in toothpaste) are widely used, and caries rates have become low. [18] In other locations, fluoridation was used and then discontinued: in Kuopio, Finland, fluoridation was used for decades but was discontinued because the school dental service provided significant fluoride programs and the cavity risk was low, and in Basel, Switzerland, it was replaced with fluoridated salt. We focused on the two main objectives: the effects of fluoridation of drinking water supplies on the incidence of caries and whether fluoridation has nega› tive effects. This results in less pain, fewer fillings or teeth pulled, and fewer missed days of work and school. Centers for Disease Control and Prevention", "The changing patterns of systemic fluoride intake", "Scientific Opinion on Dietary Reference Values for fluoride", "HHS and EPA announce new scientific assessments and actions on fluoride", "FDA Issues a Letter for Manufacturers with Recommendations on Fluoride Added to Bottled Water", "Populations receiving optimally fluoridated public drinking water--United States, 1992-2006", "CDC – Bottled Water and Fluoride – Fact Sheets – General – Community Water Fluoridation – Oral Health", "The Effects of Fluoride in the Drinking Water", "Effectiveness of fluoride in preventing caries in adults", "Fluoride prevents caries among adults of all ages", "Does cessation of community water fluoridation lead to an increase in tooth decay? Colorado brown stain is used in rural Chilean areas where water fluoridation reduces health. ]:56 about 214 million of them the fluoride is mostly due these. 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