Important ingredient in U.S. water units for cavity avoidance and dental well being equity

In a recent Morbidity and Mortality Weekly Report (MMWR), scientists analyzed regular knowledge from the Centers for Disease Avoidance and Regulate (CDC)’s Water Fluoridation Reporting Method (WFRS) for 2016-2021 to verify no matter if consuming h2o fluoridation levels, measured in mg/l, achieved oral overall health advantages and minimized the dangers implicated with too much fluoride publicity for each the United States Community Overall health Service (USPHS) recommendations.

Study: Community Water Fluoridation Concentrations To Boost Success and Basic safety in Oral Well being — United States, 2016–2021. Image Credit score: novak.elcic / Shutterstock


In the U.S., just about just one in 4 young children living underneath the poverty line experience from dental caries, a prevalent persistent condition preventable by limiting fluoride exposure. Underneath the supervision of the CDC, WFRS keeps a monitor file of water program populations on a regular monthly, quarterly, and yearly basis appropriately, WFRS updates it periodically or on a yearly basis with information furnished by states and Environmental Security Agency (EPA) Drinking Drinking water Data Method, respectively. 

H2o methods that fluoridate community drinking water present knowledge on regular average fluoride stages in mg/l. For every USPHS recommendations, regular monthly average fluoride degrees of .7 mg/L are exceptional for dental caries prevention, albeit any worth ≥0.6 mg/L is efficient. 

H2o programs that optimally fluoridate drinking water have to have routine upkeep and checking to shield versus machines dysfunctions, troubles with fluoride source, and regular program shutdowns. Nevertheless, these programs in the end reduce tooth decay in almost 25% of afflicted children and adults. On the other hand, suboptimal water units that retain fluoride concentrations <0.6 mg/L do not effectively support the oral health of their communities.

Furthermore, EPA has set a safety standard of two mg/L of monthly average fluoride levels, the secondary maximum contaminant level (SMCL). Water systems maintaining average fluoride levels under SMCL could prevent dental fluorosis in children, a disease that changes the appearance of tooth enamel in children below eight years due to hypermineralization resulting from excessive fluoride intake.

About the study

In the present study, researchers examined the performance of U.S. water systems reporting fluoride levels from the perspectives of preventing caries and supporting USPHA-established safety standards.

To this end, they computed the population-weighted monthly fluoride levels in person-months by multiplying the average monthly fluoride level by the population catered to by each water system. Furthermore, the researchers monitored 54,000 WFRS water systems, of which 5,888 adjusted fluoride levels supplied water to>200 million persons. They specifically source water to the 145M inhabitants and an further 55M by h2o systems that acquire fluoridated water from adjusted water devices. Hundreds of fluoride-adjusting group h2o units reach ~200 million U.S. populace.


For the duration of 2016–2021, fluoride measurements for 16.3% of populace-weighted regular fluoride ranges documented by group h2o programs to WFRS have been a lot less than .6 mg/L accordingly, only .01% of individual-months exceeded 2. mg/L, the EPA-specified SMCL. Minimizing SMCL exceedances more could lessen dental fluorosis in young children, as explained over. The remaining 80% of inhabitants-weighted fluoride measurements claimed to WFRS were being earlier mentioned .6 mg/L, effective for caries avoidance but beneath the advised ideal amount of .7mg/ml.

Drinking water fluoridation furthers health and fitness fairness by decreasing caries, minimizing health care fiscal burden on family members, and currently being commonly available. Healthy Persons 2030 is an ongoing initiative that greater entry to optimally fluoridated water programs by up to 77.1% in 2018 to strengthen all round inhabitants health. Other nationwide programs also saved $6.5 billion on a yearly basis in dental cure expenses, e.g., tooth extractions and oblique expenses levied by adhere to-up therapy and productiveness losses.

In Juneau, Alaska, authorities ceased fluoridation, which greater the amount of dental caries-connected methods between youngsters and adolescents aged <18 years, signifying the long-term oral health benefits of fluoridated water access.

CDC carefully and regularly monitors research on the benefits and risks of fluoride exposure to make evidence-based recommendations. It continues to emphasize the community water fluoridation level of 0.7 mg/L for dental caries prevention in the U.S. Further, it diverts resources to serve communities where fluoride measurements were <0.6 mg/L to promote the benefits of community water fluoridation and meet the prespecified USPHS 0.7 mg/L recommendation.


Overall, 4,080 community water systems safely fluoridated water 99.99% of the time, with levels below the secondary safety standard of 2 mg/L specified by EPA. To date, access to optimally fluoridated water remains the safest and most successful method for reducing dental caries and their associated costs for communities and families.

Thus, it remains crucial to motivate water systems to collaborate with their state programs to provide monthly average fluoride levels data to WFRS and ensure it meets the USPHS recommendations to confer the benefits of adequate fluoridation for dental caries prevention.