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Why Fluoridated Water Is the Unseen Superhero of Oral Health

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fluoridation-fluoride-low income-water-cavities-tooth decay

Dental care is crucial for overall health, with some experts maintaining it can lead to or indicate issues elsewhere in the body.

In fact, the mouth provides bacteria with access to your digestive and respiratory tracts, according to the Mayo Clinic, so prioritizing oral health is paramount.

Believe it or not, simply brushing and flossing your teeth daily may not be sufficient. There’s another, often unseen factor that can help keep your mouth and teeth healthy: fluoride in your water supply.

Casey Hannan, M.P.H., the division director of the Centers for Disease Control and Prevention’s Division of Oral Health, pointed out that about 35% of U.S. households don’t have access to this critical cavity-prevention mechanism. 

“Some homes are not served by a public water system, and some public water systems lack the resources to fluoridate their water cost-effectively,” Hannan said. “Also, more than 34,000 community water systems do not currently provide optimally fluoridated water, of which an estimated 32,000 are small systems, serving about 19 million people. Many of these are systems in rural areas with less access to high-quality healthcare.”

To address these gaps, the Centers for Disease Control and Prevention (CDC) has supported an initiative to deliver tablet technology to water plants that serve 50 to 10,000 people. Overall, the effort supports 32,000 small public water systems by providing them with the option of fluoridated water — and all the health benefits that can come along with it.

The role of fluoride in dental care 

One benefit of using fluoridated water and fluoride products like toothpaste is stronger tooth enamel, and thus a lower risk for cavities, Hannan said. 

Cavities are holes in teeth that result from the erosion of tooth enamel, often from acid, according to the Cleveland Clinic

“Cavities are the most common chronic disease among childhood, yet they are preventable,” said Hannan, who added that for individuals younger than 8, fluoride “helps strengthen the adult (permanent) teeth that are developing under the gums.”

Toothaches, infections, and even the need to extract teeth can result from cavities, according to the Cleveland Clinic. Hannan said in addition to helping prevent cavities, fluoride can mitigate the severity of cavities, lessen the need for fillings and tooth extraction, and reduce pain caused by tooth decay.

“Water fluoridation prevents cavities by providing frequent and consistent contact with low levels of fluoride,” Hannan said. “By keeping the tooth strong and solid, fluoride stops cavities from forming and can even rebuild the tooth’s surface.”

Per Hannan, additional available fluoride-containing products include:

  • Fluoride toothpaste: Most toothpaste available in the United States contains fluoride. The CDC recommends brushing twice per day with a fluoride toothpaste.
  • Fluoride varnish: Fluoride varnish is painted directly on the teeth by dental or other healthcare professionals up to two times per year. Fluoride varnish can prevent 33% of cavities in children’s primary (i.e., baby) teeth. Fluoride varnish is often available in medical and clinical settings.
  • Fluoride supplements: Dentists and physicians can prescribe fluoride supplements to children at high risk for cavities and whose primary drinking water has a low fluoride concentration.

Hannan said that “even with other fluoride-containing products, such as toothpaste or mouth rinses, drinking fluoridated water reduces cavities by another 25% among children and adults. 

“These advantages,” he added, “combined with fluoridation’s contribution to dramatic declines in both the prevalence and severity of cavities, led CDC to name water fluoridation one of 10 great public health achievements of the 20th century.”

Oral health without fluoride

Oral health can affect other parts of the body, as already noted, but also daily life. Hannan pointed out untreated cavities in particular are associated with pain, disruption to work and school, and lower self-esteem.

Untreated cavities disproportionately affect communities of color. Forty percent of low-income and non-Hispanic Black adults have cavities, Hannan said. He rattled off the following statistics surrounding untreated oral disease:

  • Over 34 million school hours were lost in the United States in 2008 because of unplanned urgent dental care.
  • Over $45 billion is lost in productivity in the United States each year because of untreated oral disease.
  • Nearly 18% of all working-age adults, and 29% of those with lower incomes, report that the appearance of their mouth and teeth affects their ability to interview for a job.

“Community water fluoridation is an equal and effective way to deliver fluoride to all community members regardless of age, education, or income,” Hannan said. “It also saves money for families and the U.S. healthcare system.”

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