Position Statement of the American College of Prosthodontists
It is the position of the American College of Prosthodontists that water fluoridation is an effective public health intervention to decrease the incidence of cavities in children and adults. In communities where fluoridation has been implemented, the rate of decay typically decreases by about 25% in both children and adults.1
Fluoridation works in three ways to decrease decay. First, in the growing child, systemic fluoride is incorporated into the tooth structure, reducing solubility and increasing strength. Second, the topical action of fluoride enhances remineralization of tooth structure. Third, topical interaction with plaque reduces acid production of the bacteria in the plaque. Because fluoride contact with tooth structure is beneficial, fluoride-containing toothpastes and dentist-applied fluoride varnishes are also effective in reducing decay.
Water fluoridation has been recognized and endorsed by many organizations including the American Dental Association (ADA), the American Medical Association, and the World Health Organization, along with more than 100 national and international organizations. The Centers for Disease Control (CDC) has called fluoridation one of the 10 great public health achievements of the 20th century.1
For more than 65 years, the best scientific evidence has shown that water fluoridation is safe.
Fluoride occurs naturally in water. Community water fluoridation adjusts the existing, naturally occurring fluoride levels to an optimal level of 0.7 mg/L, which provides enough fluoride to reduce cavities but not too much, which could result in dental fluorosis. In communities without water fluoridation, information for recommended supplemental fluoride dosages can be found at the ADA website: http://www.ada.org/en/member-center/oral-health-topics/fluoride-supplements#dosschedule
In 2014, more than 74% of the U.S. population received fluoridated community water.2 The percentage of the U. S. population receiving fluoridation has increased every year since 1945.
1. Centers for Disease Control and Prevention: Achievements in Public Health, 1990- 1999: Drinking Water to Prevent Dental Caries. MMWR 1999;48:241-243. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm. Accessed on February 9, 2015
2. Centers for Disease Control and Prevention: 2014 Water Fluoridation Statistics. Available online at http://www.cdc.gov/fluoridation/statistics/2014stats.htm. Accessed May 16, 2019.
Donald A. Curtis, DMD, FACP
Approved ACP Board of Directors: March 1, 2015
Revisions approved by the ACP Board of Directors June 8, 2019
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