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Resource Library
Fact Sheet
Using Fluoride to Prevent and Control Dental Caries in the United
States
Back to Fact Sheets and FAQs
August 2001—The
Centers for Disease Control and Prevention (CDC) has issued new
recommendations on using fluoride to prevent dental caries (tooth decay). The recommendations provide guidance to health care providers, public
health officials, policymakers, and the general public on how to achieve
maximum dental decay protection while efficiently using dental care
resources and minimizing any cosmetic concerns. In 1999, CDC profiled the
wide-spread practice of fluoridating community drinking water to prevent
dental decay as one of 10 great public health achievements of the 20th
Century.
Fluoride
Facts
Fluorine, from which
fluoride is derived, is the 13th most abundant element and is released
into the environment naturally in both water and air.
Fluoride is
naturally present in all water. Community water fluoridation is the
addition of fluoride to adjust the natural fluoride concentration of a
community’s water supply to the level recommended for optimal dental
health, approximately 1.0 ppm (parts per million). One ppm is the
equivalent of 1 mg/L, or 1 inch in 16 miles.
Community water
fluoridation is an effective, safe, and inexpensive way to prevent
tooth decay. Fluoridation benefits Americans of all ages and
socioeconomic status.
Children and adults
who are at low risk of dental decay can stay cavity-free through
frequent exposure to small amounts of fluoride. This is best gained by
drinking fluoridated water and using a fluoride toothpaste twice
daily.
Children and adults
at high risk of dental decay may benefit from using additional
fluoride products, including dietary supplements (for children who do
not have adequate levels of fluoride in their drinking water),
mouthrinses, and professionally applied gels and varnishes.
Good scientific
evidence supports the use of community water fluoridation and the use
of fluoride dental products for preventing tooth decay for both
children and adults.
Fluoride was first
used purposefully to prevent tooth decay in Grand Rapids, Michigan, in
1945 by adjusting the level of fluoride in drinking water.
Fluoridation of drinking water has been used successfully in the
United States for more than 50 years.
Fluoridation of
community water has been credited with reducing tooth decay by 50%-60% in the United States since World War II. More recent estimates of
this effect show decay reduction at 18%-40%, which reflects that
even in communities that are not optimally fluoridated, people are
receiving some benefits from other sources (e.g., bottled beverages,
toothpaste).
Fluoride’s main
effect occurs after the tooth has erupted above the gum. This topical
effect happens when small amounts of fluoride are maintained in the
mouth in saliva and dental plaque (the film that adheres to tooth
enamel).
Fluoride works by
stopping or even reversing the tooth decay process. It keeps the tooth
enamel strong and solid by preventing the loss of (and enhancing the
reattachment of) important minerals from the tooth enamel.
Of the 50 largest
cities in the United States, 43 have community water fluoridation.
Fluoridation reaches 62% of the population on public water supplies—more
than 144 million people. (These data are from the Water
Fluoridation Fact Sheet, 1992. See more recent data in the Water
Fluoridation Fact Sheet, 2000).
Water fluoridation
costs, on average, 72 cents per person per year in U.S. communities
(1999 dollars).
Consumption of
fluids—water, soft drinks, and juice—accounts for
approximately 75 percent of fluoride intake in the United States.
Children aged 6
years or less may develop enamel fluorosis if they ingest more fluoride than
needed. Enamel fluorosis is a chalk-like discoloration (white spots)
of tooth enamel. A common source of extra fluoride is unsupervised use
of toothpaste in very young children.
Fluoride also
benefits adults, decreasing the risk of cavities at the root surface
as well as the enamel crown. Use of fluoridated water and fluoride
dental products will help people maintain oral health and keep more
permanent teeth.
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