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Water fluoridation
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Water fluoridation
Water fluoridation is the controlled addition of fluoride to public water supplies to reduce tooth decay. Fluoridated water maintains fluoride levels effective for cavity prevention, achieved naturally or through supplementation. In the mouth, fluoride slows tooth enamel demineralization and enhances remineralization in early-stage cavities. Defluoridation is necessary when natural fluoride exceeds recommended limits. The World Health Organization (WHO) recommends fluoride levels of 0.5–1.5 mg/L, depending on climate and other factors. In the U.S., the recommended level has been 0.7 mg/L since 2015, lowered from 1.2 mg/L. Bottled water often has unknown fluoride levels.
Tooth decay affects 60–90% of schoolchildren worldwide. Fluoridation reduces cavities in children, with Cochrane reviews estimating reductions of 35% in baby teeth and 26% in permanent teeth when no other fluoride sources are available, though efficacy in adults is less clear.[needs update] In Europe and other regions, declining decay rates are attributed to topical fluorides and alternatives like salt fluoridation and nano-hydroxyapatite.
The United States was the first country to engage in water fluoridation, and 72% of its population drinks fluoridated water as of 2022. Globally, 5.4% of people receive fluoridated water, though its use remains rare in Europe, except in Ireland and parts of Spain. The WHO, FDI World Dental Federation, and Centers for Disease Control and Prevention endorse fluoridation as safe and effective at recommended levels. Critics question its risks, efficacy, and ethical implications.
The goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies. Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide. Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society, and it greatly affects the quality of life of children, particularly those of low socioeconomic status. In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there because of changing diet and inadequate fluoride exposure. In the U.S., minorities and the poor both have higher rates of decayed and missing teeth, and their children have less dental care. Once a cavity occurs, the tooth's fate is that of repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years. Oral disease is the fourth most expensive disease to treat. The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of congenital hypothyroidism and goiter.
The goal of water fluoridation is to prevent a chronic disease whose burdens particularly fall on children and the poor. Another of the goals was to bridge inequalities in dental health and dental care. Some studies suggest that fluoridation reduces oral health inequalities between the rich and poor, but the evidence is limited. There is anecdotal but not scientific evidence that fluoride allows more time for dental treatment by slowing the progression of tooth decay, and that it simplifies treatment by causing most cavities to occur in pits and fissures of teeth. Other reviews have found not enough evidence to determine if water fluoridation reduces oral-health social disparities.
Health and dental organizations worldwide have endorsed its safety and effectiveness at recommended levels. Its use began in 1945, following studies of children in a region where higher levels of fluoride occur naturally in the water. Further research showed that moderate fluoridation prevents tooth decay.
Fluoridation does not affect the appearance, taste, or smell of drinking water. It is normally accomplished by adding one of three compounds to the water: sodium fluoride, fluorosilicic acid, or sodium fluorosilicate.
These compounds were chosen for their solubility, safety, availability, and low cost. 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.
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Water fluoridation
Water fluoridation is the controlled addition of fluoride to public water supplies to reduce tooth decay. Fluoridated water maintains fluoride levels effective for cavity prevention, achieved naturally or through supplementation. In the mouth, fluoride slows tooth enamel demineralization and enhances remineralization in early-stage cavities. Defluoridation is necessary when natural fluoride exceeds recommended limits. The World Health Organization (WHO) recommends fluoride levels of 0.5–1.5 mg/L, depending on climate and other factors. In the U.S., the recommended level has been 0.7 mg/L since 2015, lowered from 1.2 mg/L. Bottled water often has unknown fluoride levels.
Tooth decay affects 60–90% of schoolchildren worldwide. Fluoridation reduces cavities in children, with Cochrane reviews estimating reductions of 35% in baby teeth and 26% in permanent teeth when no other fluoride sources are available, though efficacy in adults is less clear.[needs update] In Europe and other regions, declining decay rates are attributed to topical fluorides and alternatives like salt fluoridation and nano-hydroxyapatite.
The United States was the first country to engage in water fluoridation, and 72% of its population drinks fluoridated water as of 2022. Globally, 5.4% of people receive fluoridated water, though its use remains rare in Europe, except in Ireland and parts of Spain. The WHO, FDI World Dental Federation, and Centers for Disease Control and Prevention endorse fluoridation as safe and effective at recommended levels. Critics question its risks, efficacy, and ethical implications.
The goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies. Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide. Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society, and it greatly affects the quality of life of children, particularly those of low socioeconomic status. In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there because of changing diet and inadequate fluoride exposure. In the U.S., minorities and the poor both have higher rates of decayed and missing teeth, and their children have less dental care. Once a cavity occurs, the tooth's fate is that of repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years. Oral disease is the fourth most expensive disease to treat. The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of congenital hypothyroidism and goiter.
The goal of water fluoridation is to prevent a chronic disease whose burdens particularly fall on children and the poor. Another of the goals was to bridge inequalities in dental health and dental care. Some studies suggest that fluoridation reduces oral health inequalities between the rich and poor, but the evidence is limited. There is anecdotal but not scientific evidence that fluoride allows more time for dental treatment by slowing the progression of tooth decay, and that it simplifies treatment by causing most cavities to occur in pits and fissures of teeth. Other reviews have found not enough evidence to determine if water fluoridation reduces oral-health social disparities.
Health and dental organizations worldwide have endorsed its safety and effectiveness at recommended levels. Its use began in 1945, following studies of children in a region where higher levels of fluoride occur naturally in the water. Further research showed that moderate fluoridation prevents tooth decay.
Fluoridation does not affect the appearance, taste, or smell of drinking water. It is normally accomplished by adding one of three compounds to the water: sodium fluoride, fluorosilicic acid, or sodium fluorosilicate.
These compounds were chosen for their solubility, safety, availability, and low cost. 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.
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