Facts and Further Resources

First some basics...

  • Fluoride occurs naturally in water.  It is the natural way to prevent tooth decay.  It is in Yarmouth water already, although at a level below what is optimal for sound dental health.  The process of fluoridation adjusts the level to approximately 1 ppm (part per million), the recommended range being from 0.7 to 1.2 ppm depending upon the individual community.  (Interestingly enough, the water off Yarmouth beaches, which everyone delights in swimming in, has about 1.2 to 1.5 ppm.)
  • Fluoride works in two ways: by strengthening the enamel in the developing teeth to be more resistant to the acids formed by decay-causing bacteria (this is of principal benefit to those 18 and younger); and by providing an environment in the mouth where very early decay can be reversed (this is where fluoridation even benefits adults).
  • Fluoridation is safe.  At the 1 ppm level, its only side effect is a slightly elevated chance of developing small white spots on the teeth called fluorosis, which can be difficult for the untrained eye to detect.  Fluorosis is cosmetic, and does not affect the structure of the teeth, and almost always comes about because kids around age 2, just learning to brush, haven't yet learned to spit out the toothpaste.  Having them use only a pea-sized amount of toothpaste, and spitting out when finished brushing, virtually eliminates the occurrence of fluorosis.
  • Prior to widespread use of water fluoridation, 98 out of 100 Americans experienced some tooth decay by the time they reached adulthood.  In the 1940s, with the advent of public water fluoridation, there began a 56% reduction in cavities for children 12-14 years of age.

Now for some realities...  Against the slightly elevated chance of developing small white spots on teeth- which can occur regardless of the fluoride level in water- are these very real and sobering findings of what happens in the absence of community water fluoridation:
  • A 2003 survey of 3rd-graders in one Yarmouth elementary school revealed that 46.8% already had a history of decay, and 25.5% had untreated decay in their teeth.
  • A health screening done earlier this school year of 55 pre-K through 3rd-graders showed 52% had untreated decay.  All this in kids no older than 8, and all this for something that is preventable.

Further resources...  Comprehensive and authoritative information can be found at the American Dental Association's website on fluoridation at http://ada.org/public/topics/fluoride/index.asp .  See especially its section Fluoride Facts.

Another excellent source for reliable, scientifically based information is the CDC at http://www.cdc.gov/fluoridation/index.htm .  See especially under "Featured Items" the support from the Office of the Surgeon General, which can also be found here.

The Office of Oral Health at the Massachusetts Department of Public Health has several informative publications available on its web site.  The Office of Oral Health is within the Division of Primary Care and Access.

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Two very good reports giving an accurate description of oral health in the state, with particular focus on the Cape, can be found at Special Legislative Commission and Strategic Plan 2010.  At the core of each are the lack of fluoridation, and the lack of access to regular professional care, that lie behind low oral health status and the needless occurrence of decay, pain, infection, and tooth loss.
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For a look at one of the classic studies in fluoridation and in all of public health, available through these two links are the original Newburgh-Kingston, NY study from the American Journal of Public Health of June, 1950, and the follow-up to it appearing in the August, 1953 issue of the same publication.