The Department of Health and Social Services became concerned after hearing that the city and borough had stopped fluoridating the city water last summer and local medical and dental practices were not aware of the change. The Juneau Empire March 15 article, "City: Fluoride was cut off to clean effluent," brought the issue to the public light.
The Department of Health and Social Services now understands the city will resume fluoridating the water for Juneau citizens effective March 30 and will be preparing public notices to let health providers and the public know that fluoridation is being reinstated. The department acknowledges that Juneau medical and dental providers and the City and Borough of Juneau are working to resolve this issue and Juneau Public Works is resuming the benefits of water fluoridation.
According to the American Dental Association and U.S. Centers for Disease Control and Prevention, community water fluoridation and dental sealants (plastic coatings applied to the grooves and fissures of teeth) are the two main evidence-based practices for reduction in dental decay. Small amounts of fluoride occur naturally in all water sources, and varying amounts are found in all foods and beverages. In fact, the discovery of fluoride in water reducing dental decay was originally based on studies that looked at naturally occurring levels of fluoride in communities across the United States. Water fluoridation is the process of adjusting the natural level of fluoride to a concentration sufficient to protect against tooth decay, a range of from 0.7 - 1.2 parts per million.
Community water fluoridation has been used to reduce dental decay for more than 50 years. The safety and benefits of water fluoridation are generally acknowledged in the medical and dental communities. Besides the Juneau medical and dental support for water fluoridation, national organizations endorsing community water fluoridation include the American Medical Association, the American Academy of Pediatrics, the American Dental Association, the American Academy of Pediatric Dentistry and many public health organizations including the World Health Organization.
While much of the focus on reduction in dental decay is on children, water fluoridation decreases decay in adults and the elderly. Early studies on water fluoridation found reductions in dental decay as much as 60 percent in baby teeth and 35 percent in permanent teeth. More recent studies place the reduction in decay lower with more individuals using fluoridated toothpaste and receiving topically applied fluoride gels from their dentists. However water fluoridation remains recognized as the cornerstone in reducing dental decay in the population served by these water systems.
The issue Juneau Public Works faced was the question of corrosiveness of fluoride contributing to the elevation of lead and copper in drinking water. In the case of the Juneau water supply, the system has been fluoridated using sodium fluoride, a compound without acidic properties. Studies by the Environmental Protection Agency and National Association of Corrosion Engineers refuted assertions of fluoride causing corrosion in water systems. Corrosion by drinking water is primarily related to the dissolved oxygen content, hardness, water temperature, salt content and general pH (acidity) of the water.
The department recognizes that fluoridation of water systems should be done by trained water operators and fluoride levels should be tested daily to maintain fluoride within the optimal range for reduction of dental decay. For those interested in finding out more about fluoride in water systems, I recommend viewing the American Dental Association's Web site, www.ada.org, and/or the Centers for Disease Control and Prevention, Division of Oral Health Web site, www.cdc.gov/OralHealth/index.htm. These Web sites include a wealth of information based on solid research and evidence on the benefits of community water fluoridation.
The Alaska Department of Health and Social Services' mission is to protect and promote the health and well-being of Alaskans. Community water fluoridation is a key element in promoting good oral health for people of all ages, income, education or ethnicity. The department extends appreciation to the City and Borough of Juneau for carefully considering this important issue and resuming this important public health intervention.
Brad Whistler of Juneau is the dental officer for the Alaska Department of Health & Social Services.
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