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| Yes | 43% | 82 votes | Total: 192 votes | |
| No | 57% | 110 votes |
Yes
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Add to FavoritesDental caries is a very common condition affecting children and adults of all ages. Caries is a tooth demineralisation process induced by acids that result from bacterial fermentation of sugars in the foods. Fluoride is the most important factor that prevents caries, by: 1) reducing the dissolution of enamel, 2) promoting tooth remineralisation, and 3) decreasing bacteria and acid production in the dental plaque (Cheng, 2007). Fluoride can be provided by toothpaste, foods or drinking water. However, fluoride-containing toothpaste is not available to everybody, particularly to those with a poor social condition.
Fluoride in water may occur naturally or as a result of industrial fluoridation. Water fluoridation is used in many countries, among which: Australia, Brazil, Canada, England, Israel, Ireland, Spain, New Zealand, and the United States; however, only 5.7% of the World population receives adequate amounts of fluoride in water.
The U.S. Department of Health and Human Services believes that water fluoridation is one of 10 greatest public health achievements of the 20th century (http://silk.nih.gov / public/hck1ocv.@www. surgeon.fullrpt.pdf) . The decline in the prevalence and severity of dental caries (tooth decay) in America during the past 60 years has been attributed largely to the increased use of fluoride. Community water fluoridation is considered an equitable and cost-effective method for delivering fluoride to the community (Griffin, 2001; Truman, 2002; CDC, 2002). The percentage of the U.S. population served by community water systems who received optimally fluoridated water increased from 62% in 1992 to 69% in 2006 (CDC, 2008), and a national health care objective is to further increase this percentage to 75% by 2010 (U.S. Department of Health and Public Services, 2000).
In the UK, it was estimated that the proportion of children without caries was higher in those regions of the country where fluoridated water was available (NHS, 2000). A study including 6 regions of China with different degrees of water fluoridation found that the prevalence of dental caries decreased as fluoride concentration in water increased up to 0.8 mg/l (Bao, 2007). A recent comprehensive analysis of the most relevant nine studies ever published (comprising a total of 7,850 participants) concluded that water fluoridation reduced the risk of dental caries in adults by 27% (Griffin, 2008).
On the other hand, it has been shown that excess fluoride may induce dental fluorosis, which is characterized, in most severe cases, by brown stains, as well as cracking and pitting of the teeth, which has raised some concern about the safety of water fluoridation (Cheng, 2007). However, fluorosis usually occurs with drinking water fluoride content above 1 mg/l, and in children who also have a poor intake of calcium (http://en.wikipedia .org/wiki/ Dental_fluorosis). No other harmful effects of fluoride have been proved so far.
In conclusion, fluoridated water is thought to be beneficial, cost-effective, and safe, if adequate concentrations of fluoride are provided (between 0.8 to 1 mg per liter).
Learn more about this author, Stephen Janowsky.
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No
As with all drugs, fluoride compounds carry side effects and risks beyond the proclaimed benefits. For this reason, consumers should have the right to choose whether or not to undergo treatment. Fluoridation of public drinking water constitutes nonconsensual mass medication of the populace and therefore presents an ethical as well as public health issue.
Risks of Water Fluoridation
Water suppliers cannot control the individual dosage of fluoride consumed by each consumer. Fluoride in moderate to high doses is toxic and may cause a host of adverse health effects including dental and skeletal fluorosis, bone cancer, immune damage, liver and kidney damage, and endocrine disruption.
Dental Fluorosis on the Rise
Dental fluorosis is the first visible sign of fluoride overdose. Fluorosis is a mineralization disorder of the teeth in which enamel-forming cells are damaged and porosity of sub-level enamel is increased.
During the years 1999 to 2002, the U.S. Centers for Disease Control (CDC) conducted The National Health and Nutrition Examination Survey (NHANES) which found a 9 percent higher prevalence of dental fluorosis in American children than was found in a similar survey 20 years ago [http://www.cdc.gov/ mmwr/preview/mmwrhtm l/ss5403a1.htm].
Acco rding to estimates from U.S. and British Governments, 2 to 12 percent of children living in fluoridated communities have dental fluorosis [Griffin 2002; York Review 2000].
In November 2006, the American Dental Association began recommending that infants from 0 through 12 months of age avoid fluoridated water to reduce the risk of fluorosis caused by fluoride overdose.
In March 2007 at a conference of the International Association of Dental Research (IADR), the CDC reported that 41 percent of children ages 12 to 15 and 36 percent of children ages 16 to 19 show signs of fluorosis [http://iadr.confex. com/iadr/2007orleans /techprogram/abstrac t_92598.htm].
About Fluoride
The inorganic fluoride compounds commonly added to public drinking water include hexafluorosilicic acid (H2SiF6) and salt sodium hexafluorosilicate (Na2SiF6). When evaporated, hexafluorosilicic acid releases hydrogen fluoride. Upon contact with moisture, including tissue, hydrogen fluoride converts to hydrofluoric acid, which is highly corrosive and toxic.
Regardless of potential risks or benefits, fluoridation of public water sources constitutes nonconsensual medication of the populace. Water suppliers cannot regulate individual dosage of fluoride and cannot guarantee that consumers will not receive overdose. Consumers should have the right to choose whether or not to receive medical treatment.
Learn more about this author, Sara Mcgrath.
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