Water Fluoridation Principles and Practices
|Publication Date:||1 January 2016|
The goal of this manual is to assist with the planning and operation of fl uoridation systems by decision makers, design engineers, and water utility personnel. This chapter discusses fl uoride occurrence, growth of community water fl uoridation, and legal issues surrounding fl uoridation. The regulatory requirements of community water fl uoridation are also addressed, including both federal regulations and the varying approaches states have used to implement fl uoridation programs. Additionally, fl uoridation outside of the United States is discussed.
Fluoridation in this manual refers to the addition of fl uoride to drinking water to maintain a recommended level to improve oral health. Fluoridation was named as one of the Ten Great Public Health Achievements in the 20th Century by the Centers for Disease Control and Prevention (CDC) along with the use of chlorine for disinfection of public water supplies (CDC Morbidity and Mortality Weekly Report, April 2, 1999). Control of infectious diseases has resulted from clean water and improved sanitation. Infections such as typhoid and cholera transmitt ed by contaminated water, a major cause of illness and death early in the 20th century, have been reduced dramatically by improved sanitation. Water fl uoridation was fi rst implemented in 1945, and in 1951, the National Research Council (NRC) of the National Academy of Sciences (NAS), the US Surgeon General, and professional organizations including the American Water Works Association (AWWA) and the American Dental Association (ADA) recommended that communities implement water fl uoridation. The US Public Health Service (USPHS) recommended a range of 0.7 to 1.2 mg/L (based on annual average ambient temperature) as part of the 1962 Drinking Water Standards. In 2011, the US Department of Health and Human Services (USHHS) proposed changing the recommended fl uoride level in drinking water to a single value of 0.7 mg/L. According to national health surveillance statistics reported by the USPHS and the CDC, the number of people with access to fl uoridated water continues to increase and in 2012, 210.6 million people in the United States had access to fl uoridated water.*
* 2012 Water Fluoridation Statistics from the US Centers for Disease Control (CDC).