Clean and safe drinking water is an important environmental factor that public health departments have to deal with



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Clean and safe drinking water is an important environmental factor that public health departments have to deal with. In the 19th century, unclean water was a cause of many epidemics in the United States (Schneider, 2011). Since then, clean water has been an important goal throughout the United States. However, people argue over what should and should not be added to water. Fluoride is currently a controversial additive in water in the United States.

Fluoride is added to water throughout the United States. However, some people argue fluoride should not be added to water and is not a necessary additive to drinking water. There are even organizations claiming fluoride is unsafe for drinking. However, the Centers for Disease Control and Prevention (CDC) reported fluoride is an important additive to water to prevent tooth decay (CDC, 2011). Water with fluoride is especially important to those children and adults who do not brush their teeth as recommended with toothpaste containing fluoride. The CDC claims water with the recommended amount of fluoride additives is safe and has been proven safe by multiple scientific studies (CDC, 2011). There is a risk for excessive fluoride exposure which may cause teeth damage especially to children under the age of 8. However, this risk would involve children being exposed to higher amounts of fluoride than the amount recommended for drinking water combined with the amount in toothpaste (CDC, 2011). The amount of fluoride additive recommended was decreased in 2010 due to the general public having more exposure to fluoride in dental hygiene products (CDC, 2011). However, this change in the recommended dose increased the controversy about fluoridated water. Many people began to argue that instead of decreasing the amount of fluoride in water, fluoride should just not be added at all.

The controversial issues regarding fluoridated water affect a very large portion of citizens in the United States. 73.9% of people in the United States were reported to drink fluorinated water in 2010 (CDC, 2012). That number proves how large of an impact adding, or not adding, fluoride to water has on a community. As the amount of people who have private water from wells decrease, the amount of people exposed to fluoridated water will increase. Therefore, the decision to have fluoridated water impacts the majority of citizens throughout the United States.

As aforementioned, the CDC supports fluoride added to water as do public health departments throughout the country. Fluoridated water has been shown to save money by preventing dental decay and therefore has been proven to be cost effective (Griffen, Jones, & Tomar, 2001). Therefore, everyone in the community benefits from fluoridated water.

Fluoridated water has been proven to be beneficial to entire communities throughout the United States. Water that has not had fluoride added to it is not unsafe; however, there would be a large health impact if no water had the fluoride additive. For example, understanding fluoride is the main factor behind preventing tooth decay, one can understand how fluoridated water impacts the community. The decrease of tooth decay in the last 65 years has been noted to be linked to communities having fluoridated water (CDC, 2011). By not having fluoride as an additive, communities would be putting the public at risk for tooth decay and more dental problems overall. The decrease in fluoridated water would decrease human exposure to fluoride and therefore, could increase the amount of tooth decay in a community.

Since studies have proven the importance of fluoride in water, many different strategies and programs have been initiated to ensure public water can continue to have fluoride in it. Fluoride added to water is not regulated at a federal level but instead, regulated at a local or state level (CDC, 2011). However, the Department of Health and Human Services (HHS) provides federal recommendations for the amount of fluoride to be added to water. This current level is 0.7 milligrams per liter( CDC, 2011). It is important to note that communities are not federally forced to follow this recommended level. However, U.S. Environmental Protection Agency’s (EPA) mandates no public water source can have fluoride levels over 4.0 milligrams per liter (CDC, 2011). This max level is enforced with public water throughout the United States.


Since fluoridation of water is not federally enforced, each state mandates the addition of fluoride different. For example, in Ohio, fluoridated water has been mandated throughout the state by law since 1969 but referendums have been passed in 23 communities to be excluded from this law (Ohio Department of Health, 2012). Wisconsin also allows each local community to make the decision about fluoridated water. However, due to the high amount of private wells in rural Wisconsin, fluoride is exposed to the public in other ways. For example, some schools where fluoridated water is not common due to the high amount of private wells, fluoride mouth washes are provided at schools (Wisconsin Department of Health Services, 2012). Both of these states are good examples of how state health departments have followed the recommendations of the CDC and the EPA to encourage the use of fluoride added to water.


Overall, health departments throughout the United States are dealing correctly with the controversial subject of fluoridated water. Although some would argue fluoride added to water is not necessary, scientific research has proven otherwise. As mentioned earlier, the CDC reported 73.9% of the United State’s population receiving fluoridated water (CDC, 2012). With that statistics, it is clear to see public health departments throughout the country are following the recommendations of the CDC and the EPA to include fluoride in public water. With more people using public water, the percent of those with exposure to fluoridated water will increase. Therefore, the overall dental health of the population will increase throughout the United States based on studies showing fluoride increases dental health. I agree with these studies and believe fluoride should be added to water. After reading information both for and against fluoride use, I have found more scientific studies proving fluoride is more beneficial than harmful to one’s health. Also, I think it is very important to keep in mind there are many children in poverty that are not fortunate enough to have toothpaste or mouthwash every day. These children are the ones who depend most on fluorinated water. Therefore, I think fluorinated water is best for the community as a whole to ensure those needing fluoride the most have a way to get it.

Centers for Disease Control. (2011). Community water fluoridation: Questions and answers. Retrieved October 10, 2012 from http://www.cdc.gov/fluoridation/fact_sheets/cwf_qa.htm#7


Centers for Disease Control (2012). Statistics. Retrieved October 10, 2012 from http://www.cdc.gov/fluoridation/statistics.htm

Griffin, S.O., Jones, K., Tomar, S.L. (2001). An economic evaluation of community water fluoridation. Journal of Public Health Dentistry, 61(2), 78-86


Ohio Department of Health (2012). Fluoridation. Retrieved October 10, 2012 from http://www.odh.ohio.gov/odhprograms/ohs/oral/oralprev/fluoridation.aspx


Schneider, M. J.( 2011). Introduction to public health ( 3rd ed.). Mississauga, Ontario: Jones and Bartlett Publishers Canada

Wisconsin Department of Health Services (2012). Wisconsin oral health program: School based fluoride mouth rinsing program. Retrieved October 10, 2012 from http://www.dhs.wisconsin.gov/health/Oral_Health/programs/FluorideMouthrinse.htm


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