Fluoride in Drinking Water

Water Fluoridation

Water fluoridation is the process of managing fluoride in water supply to reduce tooth decay (Chronic disease). Fluorine has a negative ion with the name of fluoride, it occurs naturally from many sources including water, soil, sea water, food items and in plants. Chemical formula of Fluorine is F. The level of fluoride present in water reduces cavity and generates low level of fluoride in saliva. Tooth decay is destruction of tooth enamel and it occur at all level/ stages of age. It can only be repaired by minerals in saliva and fluoride. In many countries fluoride is added in water to prevent tooth decay.

USA has introduced the system of Public water fluoridation and now their major population is drinking fluoridated water. The results have clearly shown a major achievement in health industry where fluoridated water is provided to the people. People with the problem of dental caries (tooth decay) suffers pain and infection which creates difficulty in eating and people ultimately move to the dentist for either filling or removal of the teeth. WHO and FDI are the major organization that supports water fluoridation. These organizations have conducted different studies to prove the effectiveness of fluoridated water for preventing tooth decay at different stages of age.

• Reasons and Benefits of Fluoridation for Consumer: Besides so many reasons and benefits, some of them are given below:

1. Prevention of tooth decay: Fluoridated water is the most efficient way to prevent from the Chronic Disease known as Tooth decay. Fluoride along with calcium and phosphate develops a powerful system to prevent from cavities. Therefore, fluoride in water is most beneficial to strengthen our teeth.
2. Protection against cavity at all ages: Different studies have evaluated that tooth decay has reduced for about 25% in children and adults.
3. Presence of fluoride in all water: Fluoride is naturally available in fresh water, sea water and in rain water in low concentration.
4. Effectiveness and safety: Oral health is highly saved by fluoridated water. It is the most effective and safe method of preventing tooth decay. Fluoridation has reduced the risk of bone fracture. It is an effective method for cavity prevention in adults at all stages.
5. Little or no access to dentists: Fluoridations lowers the level of visits to dentist and thus reduces pain.
6. Remineralization: Once tooth enamel gets destructed by bacteria they demineralize the surface of teeth which after repairs by treating them with fluoride. The reconstruction of tooth enamel is called Remineralization.
7. Saves Money: It is the most cost effective method in reducing tooth decay and is considered major health measure to save money.

People who were served with water fluoridation experienced reduced pain, less filling, lower level of teeth pull, fewer dental treatments and thus saved money.

• Technical Process of Fluoridation:

Water fluoridation is the process which generates low level of fluorides in saliva (estimated about 0.04 mg/L per person). Fluorides are responsible to control the cavities and lower the rate of their production. Taking sugary foods gives rise to the production of acid by bacteria in the mouth. This acid weakens the teeth by taking away minerals from the surface of the teeth. This surface is called enamel. Fluoride plays major role in strengthening the surface (enamel) of teeth. These fluorides help in rebuilding the enamel and thus stops cavity formation.

Fluoridation involves the two processes called Demineralization and Remineralization. Demineralization is the process in which due to sugary foods, bacteria produces acid in our mouth which weakens our enamel and thus damage our teeth. Fluoride plays a vital role in protecting our teeth from demineralization. When fluoride assembles our damage teeth and strengthen the surface of our teeth, this is called Remineralization.

In many countries the concept of Community Water Fluoridation has introduced. It is the adjustment of fluoride amount in drinking water for prevention of tooth decay. But there are many other alternative ways people are following to get sufficient amount of fluoride to prevent tooth decay. These includes tooth pastes, dietary supplements, mouth washes and milk fluoridation technique. Community water fluoridation scheme was introduced to lower the risk of dental caries

Fluoridation Growth:

Water fluoridation strategy is used by US Government to protect people from dental caries and promote healthy teeth. About 79.6% of population is receiving fluoridated water and enormous growth is observed in reduction of tooth decay. The rate of community water system is increasing and maximum population is taking advantage from them. Studies have shown that there’s no particular evidence found to prove that water fluoridation is dangerous for health.

 

• Selection Process of Fluoridation:

Many different selection processes of fluoridation are used worldwide. Water contains significant amount of fluoride. Other sources are tablets, powdered milk, tooth paste and mouth rinse. Community water fluoridation is the most cost effective method of getting fluoride.

Water fluoridation is supported by World Health Organization in its functioning (Sandra White 2016). The companies responsible for fluoridation adjust the level of fluoride to 1mg/liter of water. This amount is enough for minimizing level of tooth decay in people.

Salt and milk fluoridation are more common in the regions outside USA, the reason is that these countries have less financial, technical and other political resources to facilitate people with water fluoridation. Therefore, they adopted other less costly methods to minimize the risk of dental caries (Ernest Newbrun, 2018).

In this figure the mechanism of fluoride distribution in the body is explained (Braz. Dent. J. Oct, 2019). Saliva after moving in the stomach gets distributed throughout the body. This ingestion of fluoride is mainly present in water and foods prepared with fluoridated water. The purpose of fluoridated water is to control the severity of dental caries and is one of the cheapest measure of health.

Fluoridation does not change the taste and color of the drinking water. The process includes addition of any of the three compounds.

1. Fluorosilicic acid (63% of population is receiving fluoridated water with this compound).
2. Sodium fluoride (9% of population is receiving water fluoridated with this compound)
3. Sodium fluorosilicate (28% of population is receiving fluoridated water with this compound).

• Impacts of its Application:

1. The major impact of water fluoridation is the reduced rate of tooth decay. According to American research the rate has reduced from 20-40%.
2. It is the most cost effective method of taking relieve from chronic disease (tooth decay) and is also a money saving strategy of taking care of teeth (Kevin L. Haney, Kay S. Beavers, 2019).
3. There are some adverse impacts of fluoridation (Stephen Peckham & Niyi Awofeso, 2014). One is that there is inability among individuals about the suitable amount of fluoride dose. This means that there is no safe limit for ingestion of fluoride and hence it can cause serious health problems.
4. Another adverse impact of fluoride is the production of brittle teeth.
5. Dental Fluorosis is a change in the appearance of teeth and is the global impact of fluoridation. It occurs when there is high level of fluoride ingested. People who consume too much fluoride faces the problem of dental fluorosis.
6. Skeletal Fluorosis is the impact in which large amount of fluoride is ingested and thus results in chronic metabolic bone disease. It is bone disease and common symptoms are joint pains and muscular stiffness.
7. Some harmful effects of fluoridation include:
8. Impaired brain development
9. Cancer
10. Bone fracture
11. Besides the benefits of water fluoridation, there are some health issues encountered when fluoride is taken either in less or huge amount. The two types of toxicities that occur in a person’s life are Acute (when greater amount of fluoride is taken) and Chronic (when small amount of fluoride is taken). The impact in both the cases can lead to health problems. Therefore, scientists need to finalize the proper amount of fluoride to be taken by individuals

• Conclusion (Sustainability and Future Application):

Studies have shown that water fluoridation is a safe and effective health measure in reducing the severity of tooth decay.

1. Supplements of Fluoride needs to be suggested to those areas where water fluoridation is not possible.
2. Countries enriched in rural populations needs to adopt technical processes for salt fluoridation, as these countries lack a central water system.
3. New convincing scientific methods should be introduced to promote sustainability and implementation of the use of water fluoridation.
4. The future use of water fluoridation may reduce the severity of dental caries, therefore, scientists needs to conduct detailed research on the optimum use of fluoride on daily basis. It needs to be considered as a serious health issue.
5. In case of discontinuing the process of water fluoridation there will be a radical increase in the number of people facing tooth decay.

References:                                                                        

• Stephen Peckham & Niyi Awofeso (2014), A Critical Review of the physiological effects of ingested fluoride as a public health intervension, Published Online
• Sandra White (2016), “Water fluoridation-what it is and how it helps dental health”, Published: Public Health England.
• Ernest Newbrun (2018), “Fluoridation Facts”, USA, Published by: NFAC (National Fluoridation Advisory Committee)
• Kevin L. Haney, Kay S. Beavers (2019), “Pediatric Dentistry” 6^th Edition, Published by: ELSEVIER
• Linuz Aggeborn and Mattias Ohman (2021), “The effects of fluoride in drinking water”, Chicago, Published Online January 12, 2021
• Dent. J. (Oct, 2019), “Systematic Effects of Water Fluoridation”, Brazil, Published by: Scielo