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Frequently Asked Questions
Fluoride | Date Posted: 12/1/2001
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Common questions about water fluoridation
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WHAT IS WATER FLUORIDATION?
All water supplies have some natural fluoride in them and the water fluoridation process just involves adding or removing fluoride to the level that protects dental health. It does not involve adding anything to the water that is not already there. There is no chemical difference between fluoride present naturally and that which is added to the water supply.
WHAT ARE THE BENEFITS OF WATER FLUORIDATION?
Drinking fluoridated water increases the resistance of teeth to decay, resulting in fewer cavities. This means fewer fillings, fewer extractions, fewer visits to the dentist and lower dental bills - resulting in better smiles, fewer dentures and less pain and suffering. Fluoridation will help to reduce the number of school or working hours or days that are lost due to dental problems or visits to the dentist.
Fluoridation will also help in the prevention of aesthetic problems associated with decay, especially in the front teeth, problems with discomfort and problems with self-esteem. Fluoridation also indirectly reduces orthodontic problems.
This benefit applies to all teeth (baby and adult) and to all age groups in our community. All teeth, at all ages, benefit as the fluoridated water has a continuous topical action.
Despite the availability of other sources of fluoride (tablets, drops, toothpaste, professional applications), water fluoridation is still shown to be the most appropriate means of reducing tooth decay in the twenty first century. The magnitude of the fluoridation benefits has decreased in recent decades, but they are still in the range of a 20-40% reduction in tooth decay in fluoridated areas.
There is ample evidence that if water fluoridation ceases, the rate of tooth decay increases despite the use of fluoride toothpaste and supplements. The decay rate decreases again when fluoridation is re-introduced.
A community that fluoridates its water today will have teeth with approximately half as many cavities in 10 years’ time.
IF I LIVE IN A NON-FLUORIDATED WATER AREA, WHAT AMOUNT OF FLUORIDE SUPPLEMENT SHOULD I TAKE?
Fluoride tablets or drops should be used according to the following guidelines proposed by the Dental Health Committee Discretionary Fluoride Panel of the National Health and Medical Research Council.
Daily fluoride supplements are to be used ONLY in cases where the natural fluoride content of your drinking water supply is less than 0.3 mg per litre.
If you are not sure whether you water supply is fluoridated, check with a local dentist or your local water supply authority.
Daily Fluoride Dosage (in milligrams) by Age Group
Fluoride in Watermg/litre 6 months - 4 years 4-8 years 8+ years
Less than 0.3 mg/litre 0.25mg 0.5mg 1.0mg
0.3 - 0.5 mg/litre 0 0.25mg 0.5 mg
More than 0.5 mg/litre 0 0 0
If a day is missed, DO NOT double up the next day. Keep fluoride supplements out of the reach of children.
Individual fluoride tablets should contain no more than 0.5 mg.
2.2 mg of sodium fluoride provides 1.0 mg of fluoride.
When you buy your tablets from the chemist, make sure he or she explains the dosage.
Remember that fluoride in toothpaste should be also taken into account. Children should use only a small amount of child-strength fluoride toothpaste when under fluoride supplements.
WHO BENEFITS FROM WATER FLUORIDATION?
People of all ages benefit from water fluoridation.
Children benefit from the tooth decay preventive effects of water fluoridation with less tooth decay in their first and second set of teeth. Existing fillings in teeth last longer where water is fluoridated as there is less decay starting again where the filling meets the tooth surface.
The elderly and those with disabilities that prevent adequate cleaning of their teeth (including those in nursing homes), or those who require assistance with tooth brushing, will benefit from water fluoridation. This group is particularly susceptible to decay around the gum line of their teeth and water fluoridation would lower this risk factor.
Water fluoridation reduces decay and lessens the need for dental intervention. Dental treatment creates additional problems for some (e.g. diabetics, haemophiliacs, transplant patients, the immune compromised) for whom a healthy mouth is essential.
Water fluoridation is particularly beneficial in providing a preventive health measure to lower socio-economic groups who may have difficulty in implementing their own preventive care. Public health education has been shown to be effective only in the higher socio-economic groups.
An enormous amount of research has been published on the safety of water fluoridation, including any effects on the older members of the community who may have very few teeth or none at all. This extensive research has revealed no adverse health effects on the elderly or any other age group.
IS WATER FLUORIDATION 'MASS MEDICATION’?
No. Fluoridation is not mass medication any more than other disease prevention health measures. It is not a 'foreign chemical' in a water supply, but a naturally occurring element that reduces dental disease. Along with pasteurisation, water purification, and immunization, fluoridation is considered one of the four most important and successful public health measures of the twentieth century.
DOES MY WATER FILTER REMOVE FLUORIDE?
Some filters do and it is important to check with the manufacturer or supplier.
Generally speaking:
Filters That Remove Fluoride:
Ion Exchange Filters
Reverse Acinous Filters and Distillers
Filters That Don't:
Carbon Filters
Ceramic Filters
ARE THERE ANY GENERAL HEALTH SIDE EFFECTS?
No. Drinking optimally fluoridated water is not harmful to human health.
Many cities throughout the world have large amounts of natural fluoride in their water supply without water fluoridation. Artificial water fluoridation was introduced over 50 years ago, providing many opportunities to study fluoridation's side effects. The only effects of water fluoridation that have been scientifically proven are those that benefit teeth.
Numerous studies have shown that consumption of fluoride in community water supplies at the level recommended for optimal dental health has no harmful effect in humans. For generations, millions of people have lived in areas where fluoride is found naturally in the drinking water in concentrations as high as or higher than those recommended to prevent tooth decay. Research conducted among these groups confirms the safety of fluoride in the water supply.
Fluoride's safety has been monitored for the past fifty years through over 30,000 studies, and no evidence has ever been found that water fluoridation causes any health side effects.
HAS THE ISSUE BEEN FULLY INVESTIGATED IN AUSTRALIA?
Five major inquiries have addressed the issue of water fluoridation in Australia. Most were prompted by claims that new evidence showed water fluoridation to be either harmful or ineffective. Each investigation took many months to examine all available information. All the inquiries found the allegations to be unproven and fluoridation to be safe, effective and economical.
These reports are:
> Report of the Royal Commissioner into the Fluoridation of Public Water Supplies (Hobart, 1968),
> Report of the Committee of Inquiry into the Fluoridation of Victorian Water Supplies for 1979-80 (Melbourne, 1980),
> Inquiry into Water Fluoridation in the ACT by the Standing Committee on Social Policy (1991),
> The National Oral Health Survey 1987-1988 (which provided a database for Australian oral health), and
> Report by the National Health Medical and Research Council on the Effectiveness of Water Fluoridation (1991). See NHMRC document ‘The Effectiveness of Water Fluoridation’.
WHO SUPPORTS FLUORIDATION?
Water fluoridation is supported by the World Health Organisation (World Health Assembly, 1978), the Australian Dental Association, the Australian Medical Association and the National Health Medical and Research Council.
75% of Australia is currently fluoridated. In 1995, enabling legislation was passed in California for water fluoridation, so virtually all major cities in the United States of America are fluoridated.
HOW COST-EFFECTIVE IS WATER FLUORIDATION?
Water fluoridation is the most cost-effective and socially equitable method of tooth decay prevention for all members of a community.
Cost varies with the size of the population fluoridated, but averages about $1 per person per year according to American figures (Garcia, 1989). Therefore it is likely to cost less to provide a lifetime of fluoridation to an individual than it costs for a single dental filling.
CONCLUSION:
Water fluoridation is a safe, equitable, cost-effective public health initiative that responsible state and local governments should implement to reduce dental pain and disease throughout Australia.
WHERE CAN I FIND MORE INFORMATION ON FLUORIDATION?
The following website provides extensive information on fluoridation:
www.ada.org.au/oralHealth/fluoridation.aspx
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More questions in this category:
Are there alternatives to water fluoridation?
What is fluorosis?
Does My Water Filter Remove Fluoride?
Common questions about fluoride
How much fluoride should I give my child?
Who should use fluoride toothpaste?
Where can I find more information on fluoridation?
Common questions about water fluoridation
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