So what is water fluoridation I hear you ask? It is simply the adjustment of fluoride in drinking water to a level that helps protect teeth against decay. Can I taste the difference at all between water with fluoride and without? No, adding fluoride does not alter the taste or smell of water, no matter what you think.
Here in Victoria, the maximum level of fluoride in drinking water is 1 milligram per litre (mg/L), or 1 part per million (ppm), as recommended by the World Health Organization (WHO). As a comparison, the amount of fluoride in children’s toothpaste is 400–500 ppm and regular toothpaste is 1,000 ppm.
What is fluoride exactly? It’s a naturally occurring compound found in plants and rocks. It is also found at very low levels in almost all fresh water. It occurs naturally at a beneficial level in the local water supplies of some Victorian communities. Sea water has approximately the same fluoride level as that used in community fluoridation programs.
So now you know what it is, let Dobson Dental tell you how it works. Tooth decay occurs when acid destroys the outer surface of the tooth. The acid is produced by bacteria in the mouth from food and drinks containing sugar. Fluoride works by helping to strengthen the mineral structure of teeth, it acts like a repair kit, repairing the early stages of tooth decay before it becomes permanent.
Are there many benefits at all to water fluoridation? Community water fluoridation helps to protect teeth against decay in people of all ages, from young to older people. It’s a fair way of delivering the benefits of fluoride to the community, regardless of individual age, education, income or motivation.
Wait, is there any evidence to support this? Yes, actually there are numerous studies and reviews that have confirmed the effectiveness of water fluoridation. Researchers from the Australian Research Centre for Population Oral Health (ARCPOH) have presented results from a study that examined the effectiveness of water fluoridation on children’s dental health across four Australian states – Queensland, Victoria, Tasmania and South Australia.
5–6-year-old children who have lived for more than half their lives in areas with water fluoridation have 50 per cent less tooth decay in their baby teeth than children who have not lived in areas with water fluoridation. 12–13-year-old children who have lived for more than half their lives in areas with water fluoridation have 38 per cent less tooth decay in their adult teeth than children who have not lived in areas with water fluoridation.
Water fluoridation is not just for children. A recently published study was based on data collected from the National Survey of Adult Oral Health 2004–06. Dental examinations of 5,505 adults from around Australia found significantly less decay experience in adults who drink fluoridated water.
Prevention is still necessary! Water fluoridation and fluoride toothpaste have contributed to a dramatic reduction in tooth decay in Australian children, but decay levels have been rising again since the mid-1990s. By the age of six, more than half of Australian children have already had tooth decay.
Increasing rates of tooth decay in Australia may possibly be because changes in diet or people drinking more soft drinks. It is important to maintain recommended fluoride levels in water to ensure that rates of tooth decay do not increase significantly.
Tooth decay is still a significant problem in Victoria. In 2013–14, more than 4,400 children under the age of 10, including 193 two year olds and 694 four year olds, required general anaesthetics in hospital for treatment of dental decay. In Victoria, 95 per cent of all preventable dental admissions to hospital for 0–9 year olds are due to dental decay.
Here at Dobson Dental we can’t stress enough how important it is to look after teeth throughout your life, as good dental health has a direct impact on overall health. Severe tooth decay can affect appearance, self-esteem and social interaction. It can also affect the ability to eat and chew, which in turn can affect general health. In children, if baby teeth are lost too early because of decay, their adult teeth may not develop in the correct position, creating dental complications later in life.
How do Melbourne Water get the fluoride into my drinking water? Fluoride is added to drinking water supplies at the water treatment plant via a carefully controlled and monitored process. Monitoring also occurs at the tap to ensure compliance with the Australian Drinking Water Guidelines. The fluoride plants are incorporated into the water treatment plant’s risk management plan and are managed in accordance with the Safe Drinking Water Act 2003.
Is it just Victoria who have a water fluoridation community? Nope, this process is carried out internationally in countries such as New Zealand, Hong Kong, Singapore, the United Kingdom, Ireland, Canada and the US. Globally, more than 350 million people benefit from community water fluoridation programs. More than 50 million people benefit from naturally fluoridated water at optimal levels to prevent tooth decay. In February 2008, England’s Department of Health provided £42 million to extend water fluoridation over the next three years. In the US, water fluoridation was initiated in 1945 and the number of communities and people who benefit from it is continuing to increase. In 2012, 74.6 per cent of the US population on public water systems, or 211 million people, had access to fluoridated water.
We know what you’re thinking now, one last question? Is water fluoridation safe? Yes! Systematic reviews from health authorities around the world consistently find that water fluoridation does not cause harmful effects.
According to academic clinicians from the Department of Allergy, Immunology and Respiratory Medicine at Melbourne’s Alfred Hospital, there is no clinical or scientific evidence that fluoridation causes allergies or affects immunity at the optimal 1 mg/L. Specifically, they state ‘ … during the past 25 years, whether in Melbourne or in the UK, we have never seen a patient with any respiratory symptoms nor any allergy like symptoms that could be attributed to fluoride at 1ppm [1 mg/L] as in our fluoridated water’.
Kidney Health Australia recommends water as the fluid of choice to satisfy thirst and has stated ‘there is no evidence that consumption of optimally fluoridated water poses any health risks to people with chronic kidney disease, although only limited studies addressing this issue are available’. Importantly, Kidney Health Australia has not called for the cessation of water fluoridation.
An Australian review in 2008 found there is a significant body of evidence demonstrating that the consumption of optimally fluoridated water is not associated with cancer risk. Also, medical specialists confirm there is no credible evidence of a link between water fluoridation and thyroid disease, stating ‘ …there is no scientifically acceptable evidence that fluoridation increases the incidence of thyroid disease’.
So there we have it ladies and gentlemen, we hope that has covered all your need to know questions surrounding water fluoridation, if not, just ask when your next in visiting us at Dobson Dental.
Victorian Dentist publication – December 2015