1 / 36

A Tennessee Perspective on Community Water Fluoridation

A Tennessee Perspective on Community Water Fluoridation. David E. Brumley, DDS, MPH South Central Region November 16, 2006. Community Water Fluoridation. Centers for Disease Control and Prevention Community water fluoridation is one of ten great public health achievements

inga
Download Presentation

A Tennessee Perspective on Community Water Fluoridation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Tennessee Perspective on Community Water Fluoridation David E. Brumley, DDS, MPH South Central Region November 16, 2006

  2. Community Water Fluoridation Centers for Disease Control and Prevention Community water fluoridation is one of ten great public health achievements of the 20th century. MMWR April 2, 1999, Vol. 48 (12)

  3. Community Water FluoridationWhat is water fluoridation? • Small amounts of fluoride are present naturally in all water sources. • Water fluoridation is the precise adjustment of the natural fluoride concentration in a public water supply up to the level recommended for preventing tooth decay. • The USPHS has established the optimal concentration for fluoride in water supplies in a range of 0.7 to 1.2 parts per million.

  4. Historical Perspective • At the turn of the 20th century, Dr. Fredrick S. McKay moved from Philadelphia to Colorado Springs, Colorado and opened a dental practice. • He noticed that many of his patients exhibited a peculiar condition referred to along the Continental Divide as ‘Colorado Brown Stain.’ • In 1908, he initiated a study and found that this condition was prevalent among long-term residents who were born in the area. It was also endemic to other communities along the Continental Divide. • Dr. McKay and Dr. G.V. Black wrote the first detailed clinical description of mottled enamel which is now termed fluorosis.

  5. Historical Perspective • In 1928, Dr. McKay discovered the agent in the drinking water that caused mottled enamel also inhibited dental caries. • In 1931, Dr. McKay sent samples of this water to an Alcoa chemist named H.V. Churchill who identified the causative agent as fluoride. • In the 1930s, Dr. McKay and Dr. H. Trendley Dean of the USPHS collaborated to explore the possibility of adjusting the level of fluoride in drinking water to reduce dental caries. • In the 1940s, four classic studies were begun which proved the benefits of adding fluoride to community water supplies. • Grand Rapids, MI – Muskegon, MI • Newburgh, NY – Kingston, NY • Evanston, IL – Oak Park, IL • Brantford, Ontario – Sarnia, Ontario

  6. When Fluoridation is Discontinued

  7. Bristol Crossville Cookeville Cleveland Chattanooga Cowan Lawrenceburg Nashville Paris

  8. Milan, Tennessee • In March 1951, Milan became the first city in Tennessee and the second city in the Southeast to adjust the level of fluoride in its community water supply for the prevention of dental caries. • As a result, five years later in 1956, the six-year-old Milan children had a 57 percent reduction in dental caries in their permanent teeth compared to the 1951 same-age cohort. • In addition, when compared to their counterparts in Humboldt and Trenton – two neighboring nonfluoridated cities – the 1956 Milan six-year-olds had a 62 percent and 70 percent reduction in dental caries, respectively.

  9. Systemic Effect of Drinking Fluoridated Water • 97 percent of tooth enamel is composed of hydroxyapatite. • When fluoridated water is ingested, the fluoride ion (F-) readily replaces the hydroxyl ion (OH-) during enamel formation of the tooth. • Hydroxyapatite Ca5(PO4)5OH then becomes a compound called fluorapatite Ca5(PO4)3F. • Fluorapatite at the enamel surface is less soluble and more resistant to acids produced by cariogenic bacteria.

  10. Disinfection Absorption Dechlorination Algae control Oxidation Metal coagulation Water softening Filtration pH control Iron control Coagulation Corrosion control Decolorization Fluoridation Community Water Systems >50 water treatment chemicals used for:

  11. Water Fluoridation Chemicals • Sodium Fluoride (NaF) • Crystalline powder • Relatively constant (low) solubility • pH 7.6 • Saturator Systems • Sodium Fluorosilicate (Na2SiF6) • Crystalline powder • Solubility varies with water temperature • pH 3.5 • Dry-feed Systems • Fluorosilicic Acid (H2SiF6) • Liquid • Infinite solubility • pH 1.2 • Venturi Systems

  12. Community Water FluoridationIs it safe? • Acute fatal poisoning (CLD) in adults requires the ingestion of 2.5 - 5.0 grams of fluoride in a 2 - 4 hour time frame. • In drinking fluoridated water at 1.0 ppm, an adult would have to drink 660 gallons in 2 - 4 hours to reach the lower limit of a fatal dose. • A 10kg child (12 - 18 months of age) would have to drink 85 gallons of fluoridated water (1.0 ppm) in 2 - 4 hours to reach the lower limit of a fatal dose.

  13. Community Water FluoridationWhat are the costs? $0.50 per person Average annual cost of water fluoridation in the U.S. Systems serving 2,000 or less = $0.77 - $1.16 per person per year Systems serving 2,000 - 20,000 = $0.21 - $0.95 per person per year Systems serving  100,000 = $0.12 - $0.21 per person per year In most communities, every$1 invested in fluoridation saves $38 to $80 in dental treatment costs.

  14. Community Water FluoridationStatus Healthy People 2010 Goal 75% States Currently Meeting Goal = 24 States range from: 2.3% (Utah) to 100% (Kentucky, Rhode Island, South Dakota, & the District of Columbia) CDC Fluoridation Status, 2002

  15. Community Water FluoridationStatus • 10 states, Puerto Rico, and the District of Columbia mandate statewide fluoridation through legislation. • California, Connecticut, Delaware, Georgia, Illinois, Minnesota, Nebraska, Nevada, Ohio, South Dakota • Kentucky mandates statewide fluoridation through administrative regulation. • Tennessee has a voluntary process with an emphasis on education rather than legislative mandate.

  16. Community Water FluoridationStatus Healthy People 2010 Goal75.0%

  17. Public Water System Source: http://apps.nccd.cdc.gov/gisdoh/waterfluor.aspx

  18. Total Population Source: http://apps.nccd.cdc.gov/gisdoh/waterfluor.aspx

  19. Tennessee’s Water Systems 532 Approved Systems 214 Fluoridating Systems 118 Consecutive Systems 332 Fluoridated Systems

  20. Tennessee’s 50-Year Fluoridated Cities

  21. Tennessee’s Largest Non-Fluoridating Systems

  22. 1996-97 East Tennessee Dental Health Survey 15 ETR counties 62 communities 65 schools 17,256 children

  23. http://apps.nccd.cdc.gov/MWF/Index.asp

  24. http://www.ada.org/public/topics/fluoride/facts/

More Related