Fluoridated water is the supply of drinking water that has fluoride artificially added to it. This practice of public health was praised by Center of Disease Control and Prevention (CDC) as one of ten great public health achievements in 20thcentury.
Publically fluoridated water in U.S. and Canada
The discovery of fluoride’s benefit on dental health was initiated in the 1930’s and currently practiced in 25 countries worldwide. According to U.S. statistics 2012 (CDC 2012), total U.S. population was 314 millions. 283 million people lived on community water supply system, out of which 211 million lived in the area which supplied fluoridated drinking water. The state of Kentucky has the highest percentage of fluoridated water drinking population of 99%, followed by Minnesota, Illinois and Maryland with 99%, 99% and 98%, respectively. The bottom three on this list is Oregon, New Jersey and Hawaii with 23%, 15% and 11%, respectively. According to the data from Health Canada, in 2009, only 45% of Canadian population was covered with Fluoridated water, among which the top five provinces/territories are Ontario, Manitoba, Alberta, Nova Scotia and Northwest territory with 76%, 75%, 70%, 57% and 56%, respectively, and the bottom five are Quebec, British Columba, Newfoundland and Labrador, Yukon and Nunavut with 6%, 4%, 2%, 0 and 0, respectively.
It is the rich who are against fluoridated water
From the socio-economic status (SES) perspective, supply of fluoridated drinking water provides equality, and reduces disparity in dental health regardless of SES. On the basis of this effective preventative measure, dental care will be less expensive for those at lower SES. It was found that, however, after certain years of intervention, the rich who have ideal dental care anyways, began to stand against the practice of water fluoridation in the community. Not only the rich, but the common public, who after years of water fluoridation, has benefitted from the decreased prevalence of dental caries, began to question the usefulness of the intervention of fluoridation of water.
Only 25 countries put fluoride in water
Whether or not to adapt community fluoridated water is not just a public health question, it is also a social, ethical, economic and political issue. It was analyzed the potential ethical and political reasons that holds back the application of this effective public health intervention in most countries around the world, with 25 countries opt in and most countries opt out after WHO advocated it. The twenty-five countries include the U.S., U,K, Canada, New Zealand, Australia, Hong Kong, Singapore, South Korea, etc. From the list of countries, and different coverage of water fluoridation in each country, we can see that the issue is definitely very complicated and beyond science itself.
The cities of Waterloo and Windsor in Ontario Canada turned off fluoride in 2010 and 2013, respectively. The level of fluoride in fluoridated drinking water is about 0.5 to 1 mg/L, with WHO recommendation of 1 mg/L. Meanwhile, data from Health Canada website shows that the fluoride in the natural source of drinking water varies greatly across Canada: in British Columbia, Yukon and Prince Edward Island, the levels are low from undetectable to 0.21 mg/L, in Quebec, Saskatchewan and Alberta the concentrations of fluoride are high, and in some communities are as high as 2.52-4.35 mg/L.
Nobody can avoid fluoridated water in U.S. and Canada
Water and toothpaste are not the only source of our daily intake of fluoride. Food and beverages such as tea and processed beverages also contains significant amount of our fluoride ingestion (Health Canada, 2012). It is inevitable to avoid fluoride in real life for people living in North America. Food and beverages are processed with fluoridated water everywhere, and being transported and consumed across this continent. In Toronto, for example, the level of fluoride in drinking water is about 0.54 mg/L, and is 0.28 mg/L in food and beverages.
If we think “go nature” as the only healthy way of living and any interventional measure inappropriate, the fluoride levels in drinking water should not be a criteria here in judging natural or not. Also, if it is true that there is some correlation between fluoridated water of 0.6 mg/L and health issues as some very weak evidence suggested, in the areas with higher natural concentration of fluoride in drinking water, the incidence, prevalence, morbidity and mortality of those claimed health issues among those population should be higher. However, this is not the case up to now, at least no any reports have been shown in this regard.