Episode 5: Why is Community Fluoridation Important?

community fluoridation

In this episode, Dr. Kuo discusses the benefits of community water fluoridation and addresses some of the common misconceptions. Click here to read more on Dr. Kuo’s research. 

Big takeaways

  • Fluoridated tap water is one of the best and most economical ways to prevent cavities that cannot be provided by bottled water. 
  • However, the public expresses dislike towards tap water. 
  • Most people don’t know fluoride is in tap water and they question the benefit of fluoride and fluoridated tap water.
  • Mistrusts towards tap water in low-income communities result in suboptimal fluoride intake, further contributing to increased prevalence and risk of cavity formation.
  • Education and raising awareness should remain as top priorities on the public health agenda. 
  • Multidisciplinary health care is the gold standard of modern health care.

What is Community Water Fluoridation?

Community water fluoridation refers to the addition of fluoride into the water supply. The Centers for Disease Control and Prevention has long credited community water fluoridation as one of the greatest public health contributions of the century, not only because it is a cost-efficient method to serve large populations, but also for its benefits of strengthening teeth and reducing cavity formation by as much as 25% in children and adults. 

The U.S. Department of Health and Human Services recommends 0.7 milligrams per Liter (mg/L) as the optimal concentration of fluoride in drinking water to effectively prevent cavities. However, in the 2014 LAC Water Consumption Report, Dr. Kuo and the team observe the level of fluoride in tap water varied according to the city (with 58% of the LAC population having access to optimally fluoridated tap water, 5% near-optimal, 19% partial, and 17% none).

Where Did Fluoride Come From? 

Fluoride is a natural mineral found in rocks. According to the Centers for Disease Control and Prevention (CDC), all water contains some levels of fluoride as a result of rainfall and other naturally occurring phenomena on Earth.

What Can Fluoride Do to My Overall Health? 

Oral health and physical health are a continuum. Good oral health has a significant connection to good cardiac health. Therefore, prevention is the key to good overall health. 

Since the 1930s, fluoride has proven to show direct advantages of preventing cavity formation by strengthening demineralized tooth surfaces and even rebuilding already-weakened enamel. Fluoride is beneficial to people of all ages in keeping teeth strong and healthy. Healthy and strong teeth require less dental restorations or extractions, result in less pain or complications from tooth decay, thus increase the overall quality of life. 

Is tap water safe to drink?

Yes, tap water is safe to drink in the United States. The U.S. Environmental Protection Agency outlines the Safe Drinking Water Act to regulate and protect the quality of public drinking water.  Despite the scientifically proven benefits of fluoride and the safety of community tap water, many people are not partaking in the fluoridated tap water due to various public perceptions. 

Dr. Kuo and the team noted in the article, “In underserved population, this is likely a valid concern because the quality and safety of a tap water source can be compromised for many reasons, including treatment system failure, broken or corroded pipes, or contamination with toxic metals and chemicals such as lead and arsenicdall issues that are more prevalent in lower-income neighborhoods. There have been high-profile incidents in the news that have heightened this concern. Examples include the discovery of contaminated community water supplies in Flint, Michigan, and in South Los Angeles, California. In both cases, residents perceived the government response as delayed and not proactive. Compounding this mistrust is the apparent lack of knowledge that bottled water generally is not fluoridated; many participants in the WCS did not know whether their bottled water contained fluoride.” 

As a result, low-income residents opt for bottled water despite the higher cost relative to that of tap water because they think it’s safer to drink than tap water while failing to realize there is no fluoride in bottled water. High market penetration of bottled water sales coupled with inadequate medical and dental health access and knowledge largely accentuate the risk of developing caries, especially among children and adults who live in underserved communities. 

What is the way forward?

Dr. Kuo’s article highlights an array of misconceptions on the quality and safety of tap water viewed by residents of low-income communities in Los Angeles County; this notion is likely shared by many across the nation. Dr. Kuo suggests that raising awareness and encouraging consumption of fluoridated tap water over bottled water should be an important public health priority, particularly in low-income communities and other target groups. Furthermore, Dr. Kuo stresses the significance of preventative dentistry by tailoring to the needs of the communities and providing them with regular access to dental care. 

Dr. Kuo stresses the importance of establishing a dental home. For new parents, it is highly recommended to bring your child to their first dental visit around one year of age, or upon the eruption of their first tooth, so that young children can get accustomed to dental setting, receive proper advice from trained medical professionals, and establish a good dental routine early on in life. It is imperative to recognize the significance of preventative care in dental and medical health, for good dentition alleviates dental pain, promotes better self-confidence, thus increases the overall quality of life.

ShuJie Yan

This summary was written by the very talented Shujie Yan

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