Fluoridation of Public Water Supplies: Effective Health Promoting Strategy or Unwelcome Mass Medication?
Tooth decay (or dental caries) represents one of the most significant diseases worldwide, effecting over 2 billion individuals. In 2006 in the U.S., dental caries was considered the most common chronic childhood disease (Oral Health – Healthy People). A large percentage of adults in the U.S. over the age of 50 years also have dental decay. Given the large number of affected individuals and the fact that there is no way to “regrow” damaged teeth, it comes as little surprise that preventative strategies have been developed. First and foremost has been the use of fluoride, which helps prevent dental caries. It is the active ingredient in toothpaste. Moreover, fluoride is routinely added to public water supplies in many locales across the world. This sounds like a good thing, right? It actually depends upon whom you ask. The fluoridation of public water supplies has generated much controversy over the past few decades. Let’s take a closer look at the pros and cons of fluoridation of water, and see who is for and who is against it.
Water fluoridation began in the 1940s, and controversy has swirled since this time. Proponents argue, and scientific data has since proven (Systematic Review of Water Fluoridation), that fluoridation of public water supplies decreases the burden of tooth decay. Although with significant variance, scientific studies consistently show that water fluoridation decreases cavities in children (18-60% reduction). Opponents, however, argue against it for several reasons: 1) excess fluoride intake can cause serious health problems; 2) the outcomes do not justify the cost; and 3) the dosage cannot be properly controlled. In regards to point 1, there is little scientific evidence that water fluoridation causes any adverse health consequences except dental fluorosis, which is a harmless discoloration of the teeth. Point 2 is more of a philosophical stance that is clearly a matter of opinion. In reference to point 3, if properly managed, water fluoridation can be maintained at a level that promotes dental health and minimizes adverse health risks. Opponents argue that too much fluoride could cause cancer, but scientific data do not support this argument (NHMRC Public Statement: Efficacy and Safety of Fluoridation).
So, who argues for and who argues against water fluoridation? Those against it include the International Chiropractor’s Association who argue it is “possibly harmful and deprivation of the rights of citizens to be free from unwelcome mass medication”. The Sierra Club in the U.S, the Canadian Green Party and some notable scientists have also come out in opposition to water fluoridation. Those in favor include the U.S. Centers for Disease Control (CDC), the American Dental Association, Health Canada and the World Health Organization (WHO).
You now have the basic scientific facts. Who do you agree with on this issue? Will you continue to drink fluoridated water? What about bottled or filtered water, do they contain fluoride? The answer is probably no. Whatever you decide, just know that leading scientific organizations worldwide support water fluoridation and feel that these programs are among the most significant health advances of the 20th century.