Community Water Fluoridation and Its Influence on Public Health

Introduction:

Researchers studied the connection between childhood dental decay and naturally occurring fluoride in water in the 1930s. According to the study, children who drank naturally high fluoride water experienced less tooth decay. After extensive scientific study, Grand Rapids, Michigan, became the first to add fluoride to its municipal water supply in 1945 to offer people the benefits of fluoride. The CDC ranked community water fluoridation as one of the top ten public health accomplishments of the 20th century because of its role in the substantial drop in tooth decay over the previous 75 years.

What Is Community Water Fluoridation?

The act of adjusting the amount of naturally occurring fluoride in drinking water to the ideal level for preventing tooth decay is known as the fluoridation of community water systems. Consider it like this: Fluoride water fortification is comparable to adding vitamin D to milk, iodine to table salt, and folic acid to bread and cereal. Communities that choose to fluoridate their water are becoming more numerous. Since 1945, hundreds of localities have begun fluoridating their municipal water supplies, and in 2018, almost 73 % of Americans served by community water systems had access to fluoridated water.

What Is Fluoride?

Fluoride is a mineral naturally occurring in almost all water sources and in tiny amounts in food and soil. Fluoride, the ionic form of the element fluorine, prevents or stops dental caries (tooth decay) from starting and progressing while promoting new bone growth. The majority of fluoride that people eat is present in toothpaste, other dental products containing fluoride, foods, and beverages made with fluoridated water, and fluoridated water itself.

How Does Tooth Decay Develop?

It is critical to grasp how tooth decay develops to comprehend how fluoride functions. Two straightforward, connected ways to describe tooth decay are as follows:

• Tooth decay occurs when the bacteria in the mouth degrade sugars to generate acid.

• The acid dissolves minerals from the enamel (outer covering of the teeth). As a result, acid wears away the tooth surface over time, resulting in a cavity.

How Fluoride Aids Treating and Preventing Tooth Decay?

Fluoride helps to prevent tooth decay in two ways:

1. Keeping Bacterial Overgrowth Under Control:

• Fluoride inhibits the growth of specific bacteria that may contribute to tooth decay. In addition, fluoride reduces the mouth's pH, resulting in a more acidic environment that is less favorable to germs.

• Three oral bacterial species namely Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis have been reported to be negatively impacted by fluoride.

2. Teeth Mineralization:

• The interaction of fluoride with teeth results in the mineralization of the teeth through the formation of fluorapatite. Mineralization is a chemical hardening procedure that guards against tooth damage. Even though fluorapatite is not a naturally occurring part of teeth, it is advantageous and does not harm teeth.

• The mineralization of fluorapatite caused by fluoride supplementation improves the teeth's resistance to damage from microbes, food, and beverages.

How Fluoridation of Community Water Benefits Public Health?

Fluoridation of public water systems operates in two ways. First, fluoridated tap water strengthens children's immature permanent teeth, lessening tooth decay risk. Second, fluoride enters the saliva when kids and adults swallow fluoridated tap water. Saliva containing fluoride cleans the teeth and fortifies their outer surfaces. Additionally, it guards against tooth decay.

Children and adults who use fluoridated tap water have less dental decay, less need for tooth extraction, and less discomfort and suffering due to tooth decay.

Does Fluoride Have Any Possible Adverse Effects on Public Health?

Although naturally occurring, fluoride can have negative consequences if eaten in high amounts. The maximum permitted amount of fluoride added to water in the United States as of 2015 is typically approximately 0.7 parts per million (ppm). Some health effects caused by high fluoride intake are as follows:

1. Dental Fluorosis:

• It occurs when people consume excessive fluoride while their teeth still grow beneath the gums. As a result, it causes white spots on the teeth's surface.

• Dental fluorosis has no symptoms or adverse effects other than the appearance of white patches.

• Only young children under eight with developing permanent teeth typically experience it. Additionally, toothpaste, which has substantially more fluoride than fluoridated water, is more likely to be swallowed by kids.

• Parents can lower their child's risk of getting dental fluorosis by watching over them as they brush their teeth and ensuring they are not ingesting excessive amounts of toothpaste.

2. Skeletal Fluorosis:

• Similar to dental fluorosis, skeletal fluorosis affects bones rather than teeth.

• Joint stiffness and pain are early symptoms. It can gradually change how bones are built and lead to the calcification of ligaments.

• It typically results from prolonged exposure to high fluoride levels frequently found in drinking water.

• However, fluoride levels that are too high in water can result from various factors, such as unintentional pollution from fires or explosions. In addition, fluoride has massive geologic deposits in several places, including significant portions of Africa and Asia, which can contaminate water supplies.

• A case of skeletal fluorosis is reported in the United States; however, it is uncommon. Experts concluded that a 52-year-old American man's skeletal fluorosis is due to ingestion of toothpaste.

Is Drinking Fluoridated Water Harmful?

Hundreds of research have been carried out by scientists worldwide to examine the safety of putting low levels of fluoride in drinking water. However, aside from the sporadic minor incidence of dental fluorosis, there is little evidence that fluoride added to local water systems in the United States causes health issues.

However, some assert drinking fluoridated water can lead to several health issues, such as

• Low IQ (intelligent quotient) levels in children.

• Bone cancer.

• Arthritis (joint pain in bones).

• Kidney disease.

There are conflicting findings from studies examining the relationship between fluoride and children's low IQ scores. There may be a connection between the two, according to a 2012 assessment of the research, but more extensive, high-quality studies are required.

Conclusion:

A naturally occurring mineral called fluoride is utilized in many dental products to fortify tooth enamel and stop cavities. In many American communities, fluoride is added to municipal water supplies. Although the amount of fluoride added to drinking water is considered safe, excessive fluoride exposure results in several health problems.