I'm Doctor John Iskander,
welcome to CDC's Beyond the Data.
I'm here today with Dr. Barbara Gooch
to discuss community water fluoridation.
Barbara could you for our audience orient us generally
at first to what we mean by fluoridation
or community water fluoridation?
Community water fluoridation is the adjustment
of the fluoride content of drinking water
for the prevention of tooth decay.
Overall most water contains fluoride that is generally
at levels too low to prevent tooth decay.
So, after both public health
and clinical research done during most of the 20th century,
we learned that at about one part per million
or one milligram per liter of fluoride in water carries
in communities, carries in communities, that added fluoride
to their water to that level had about a 50
to 60 per cent reduction in tooth decay.
Remember at the time
that community water fluoridation was first
introduced beginning in the 1940's, that was the main source
of fluoride, the water supply.
So one essential benefit that you've just talked
about is prevention of tooth decay.
Gooch: Exactly.
Are there other, for example, economic benefits
that we receive from water fluoridation?
Well yes, there certainly has been, has been,
an economic analysis, or have been economic analysis.
And these generally are going to look at the cost
of implementing a water fluoridation program
and the cost of the dental treatment that's prevented
by instituting such a program.
And these have generally found
that community water fluoridation is not only cost
effective but also saves costs.
One published estimate is that for every dollar spent
on community water fluoridation programs $38 are saved
in dental treatment costs annually.
What have we learned over the years about adverse effects
that might be associated with community water fluoridation?
That's a very good question, because we do get a lot
of inquiries about adverse effects.
And multiple reviews by panels of scientist over the years
and also public health professionals have assured
that not only is community water fluoridation beneficial
but it's safe.
We've had several recent reviews and those have concluded
that the only, perhaps termed "unwanted" effect,
of fluoride in water at the levels used
for community water fluoridation would be dental fluorosis.
And let me just take a minute
to explain what dental fluorosis is.
Dental fluorosis is a change in the appearance
of the tooth enamel, so it's a change
in the appearance of the tooth surface.
In the United States,
most dental fluorosis is very mild, or mild.
It's barely detectable to most individuals.
It appears as just white spots or flecks
and generally it is detectable by your dental professional.
So, we, again we have a public health intervention
which is cost beneficial- Gooch: Mm.
Hmm. -- has no evidence of serious adverse health effects.
People may be wondering though,
compared to when fluoride was originally instituted
in water supplies, we now have other sources of fluoride,
what should people know about fluoridation
in the modern environment
where there is fluoride from other sources?
Well, there are other sources of fluoride
that have become available
since community water fluoridation was introduced
in the US.
And these of course are commonly known,
fluoride toothpaste is used daily by most persons in the US,
fluoride mouth rinse is in supplements.
But, the available data indicates
that there is still an additional benefit
from drinking fluoridated tap water.
The most recent data indicates
that you have an additional benefit of about a 25% reduction
in tooth decay from community water fluoridation.
Very good information.
For people in our audience
who want more information what's a reliable source
for them to consult?
Well, I would turn to the CDC's website,
that's CDC.gov/oralhealth
and you will find additional information on fluoridation
and other oral health topics.
Thank you very much Barbara.
Please join us next month
for another addition of Beyond the Data.