Which was an indirect benefit of water fluoridation

Health Affairs. View abstract on PubMed external icon 4. An economic evaluation of community water fluoridation. J Publ Health Dent ;61 2 — View abstract on PubMed external icon 5. View Report external icon 6. Effectiveness of fluoride in preventing caries in adults. J Dent Res. View abstract on PubMed external icon 7.

J Pediatr. View abstract on PubMed external icon. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Community Water Fluoridation. Section Navigation. Facebook Twitter LinkedIn Syndicate. Cost Savings of Community Water Fluoridation. Minus Related Pages. Economic Impact Economic evaluations reaffirm the cost benefits of community water fluoridation. Halo Effect In addition to providing an oral health benefit for people with access to fluoridated water, a related analysis found that children living in communities that do not adjust fluoride may still receive partial benefits of fluoridation from eating foods and drinking beverages processed in fluoridated communities.

References 1. To receive email updates about Community Water Fluoridation, enter your email address: Email Address. Less understandably, some later anti-fluoridation activists described the corporate embrace of fluoridation as evidence of a Communist plot. It was more like a capitalist plot. From to , the secretary of the Treasury was Andrew W. Mellon, a founder of the Aluminum Company of America, better known as Alcoa.

The U. Public Health Service was then under the jurisdiction of the Treasury Department. In January , Alcoa chemists discovered high levels of fluoride in the water in and around Bauxite, Arkansas, an Alcoa company town. Eight years later, a biochemist at the Mellon Institute, in Pittsburgh, became the first researcher to call for the widespread fluoridation of water.

Additional impetus came during the Second World War. The Manhattan Project—the crash effort to develop the atomic bomb—processed uranium by combining it with huge amounts of fluorine to form uranium hexafluoride.

Large quantities of other fluoride compounds, including the DuPont refrigerant Freon, were needed. Accidents exposed employees to these little-understood substances, killing some and sickening others. Under the guise of protecting teeth, the Manhattan Project set about obtaining data on long-term fluoride exposure. Both cities added fluoride to their water.

In both cases, the control was a nearby city that did not add fluoride. The experiments were supposed to continue for at least a decade, with dentists in each city examining their patients to evaluate long-term effects. As it happened, one of the control cities fluoridated its water within seven years because its citizens had heard rumors about the benefits. Fluoridation took off.

So did the anti-fluoride movement, a loose coalition of Christian Scientists, Boston society ladies, chiropractors, biochemists, homeopaths, anti-Semites, and E. Bronner, the spiritualist soap-maker. The opposition mostly failed. Still more Americans get fluoride from soft drinks, most of which are made with fluoridated water.

Some bottled water is fluoridated too. In , Grand Rapids, celebrating its historic role, erected a foot-high powder-blue sculptural monument to fluoridation.

The fluoride revolution was not restricted to the United States. The Organization for Economic Cooperation and Development regularly surveys the progress of its 36 member nations.

One variable it tracked until recently was the number of decayed, missing, or filled adult teeth in year-olds, a measure of overall dental health. The top graph below depicts the results—uniformly positive—for six nations that have widely adopted fluoridation.

Graphs like this help explain why the Centers for Disease Control and Prevention in called fluoridation one of the top 10 public-health advances of the 20th century. Curiously, they also help explain why fluoridation is opposed by the surprisingly durable cohort of activists who barraged me on social media. The bottom graph, based on the same OECD surveys, tracks the number of decayed, missing, or filled adult teeth in year-olds from countries that have not embraced fluoridation in a significant way or at all.

Finland, Germany, Japan, the Netherlands, Sweden, and Switzerland tried fluoridation, abandoned it years later—and saw no rise in tooth decay. Read: The toxins that threaten our brains. In , the Cochrane organization waded into the debate. Founded in , Cochrane is a London-based global network of about 30, medical researchers in multiple countries that provides systematic analyses of medical issues.

Cochrane has a fiercely guarded reputation for impartiality and thoroughness. Its verdicts have global impact. Which may be why the pushback on its fluoridation work was so strong. To evaluate the studies, the team used two simple but strict criteria: They needed to have two large groups of subjects, one with fluoride the intervention group and one without the control group , and each group had to be examined at least two times. Moreover, the studies needed to be prospective meaning the scientists announced beforehand what they were looking for, then measured it as opposed to retrospective meaning the scientists sifted through historical data looking for patterns.

Scrutinizing medical databases, the Cochrane team found 4, fluoridation studies. All but of them—20 that focused on tooth decay, and that focused on dental fluorosis—failed to meet the two criteria. The Grand Rapids study is an example of these problems. Not only was it cut short when the control city, Muskegon, started fluoridating its water, but the experimenters had not established whether the two populations had similar incomes or ethnic backgrounds.

The Grand Rapids researchers cannot be much faulted for these lapses, according to the Cochrane spokesperson Anne-Marie Glenny, a researcher at the University of Manchester School of Dentistry. Few scientists understood how small imbalances between the intervention and control groups could compromise an entire trial.

And the researchers definitely cannot be blamed for the unhappy fact that their experiment—indeed, all of the original fluoride research—occurred before the introduction of Crest, the first fluoride toothpaste, in Today, given that almost all toothpaste contains fluoride, and that most people brush their teeth, assessing the impact of fluoridated water remains highly problematic.

How much was due to the soaring popularity of fluoride toothpaste and mouthwash? And how much was due to rising affluence, which generally translates into more visits to the dentist? The Cochrane group reported its work carefully. The report did not support or attack fluoridation; it only asked for more research. Nonetheless, it set off an uproar.

A blog post on the Cochrane website attracted so many vitriolic comments from anti-fluoridation zealots that the organization eventually removed it.

The story included earlier versions of the two charts in this article. Last year, JAMA Pediatrics published a large, careful study that suggested fluoridation gave extra benefit to poor children and adolescents, but it, too, had limitations—the authors could not establish whether the different families in the study ate similar amounts of sugar, for instance.

Still, the argument runs, it is ethically acceptable to force a majority to do something potentially useless if it might benefit a minority. Unless, of course, fluoridation at current levels is unsafe in some way, and the many are harmed in pursuit of a potential benefit for the few. Is it safe? Some fluoride perils are well documented. Over the long run, the body incorporates fluoride into bone, making it more prone to fracture, and into ligaments and joints, making them less flexible and sometimes making movement very painful.

Severe cases of fluorosis are crippling; most victims are elderly. As a result, fluoridation advocates and people in government must thread a needle: enough fluoride to protect against tooth decay in children, but not enough to cause problems in the long term. Alas, epidemiologists have been complaining about the safety studies for decades, according to Sander Greenland , an emeritus professor of epidemiology and statistics at UCLA.

With the new equipment, they can control the fluoride level within a very narrow range. Public Health Service that looked at this. Matters get more complex for less well-documented risks.

In October, a research team published the results of a long-term study in Canada that correlated concentrations of fluoride in the urine of pregnant women with the IQ scores, three to four years later, of their children. The IQs of the boys but not the girls in fluoridated communities were, roughly speaking, one to three points lower than those of boys in nonfluoridated communities.