Community Water Fluoridation Research Paper
Water fluoridation is the process of addition of fluorides to the drinking water supplies so as to allow good dental health. Fluorides are present everywhere in the environment. At low levels it is not harmful but higher levels of fluoride are dangerous. Small levels of fluoride prevents in tooth decay. Among children whose teeth are forming excessive fluoride level has the ability to cause dental fluorsis, where as in adults this can lead to skeletal fluorosis having joint pains, denser bones and low joint movement. Very high levels of fluorine or HFl may sometimes cause muscle spasms and may harm the lungs, heart and even cause death. But at the low levels of this it causes irritability to skins, lungs and eyes. Water fluoridation is a beneficial process but in terms of excessive levels it can become
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dangerous too. In the below paragraphs a brief description about the fluoridation process, mechanisms, advantages, disadvantages and the detailed research literature are described.
Execution process of fluoride
Fluoridation has no effect on the taste, appearance or the smell of the drinking water. It is implemented by the addition of sodium fluoride or odium fluorosilicate or fluorosilicic acid in the drinking water
Sodium fluoride is the first component that can be added to water and was used in the reference standard. It is white, odourless crystal or in powder form .the crystal form is used when handling manually and it is most expensive than other compounds (Graves RC and Stamm JW, 1985).
Fluorosilicic acid is the most common used compound for fluoride addition. It is inexpensive and it’s a byproduct of manufacture of phosphate fertilizer. It comes in different strengths and it contains a lot of water.
Sodium fluorosilicate is a salt of the fluorosilicic acid. It is in powder or fine crystal form.
All the three compounds are of low cost, soluble, safe and easily available. Fluoride occurs in water at, below or at the recommended level. In the water fluoride exists as F- ions commonly and also exists in combination magnesium as magnesium fluoride. In some cases when the water contains fluoride levels excess than the required then defluoridation is done by percolating the water through the granular beds of bone meal, bone charm activated alumina, or tricalcium phosphate. The reverse osmosis process also removes 60 to 65% of fluoride.
Toxicity of fluoride
The compounds of fluoride enter in the body by the inhalation and ingestion process. The fluoride excess levels can damage various parts and functioning of body. These are described below:
Brain: A meta analysis research shows exposure to high levels of fluoride during childhood may cause reduction in IQ level. Studies are going on to find the adverse effects of fluoride on children neurodevelopment.
Bones: The toxic levels of fluoride shows weakening of the bones and an increase in fractures of hip and wrist. The intake of fluoride beyond the levels of the drinking water for a longer period may cause skeletal fluorosis. In the Asian subcontinent its an endemic disease with symptoms of joint pain and irritable bowels
Kidney: Toxic levels of fluoride also cause kidney injury
Teeth: The purpose of water fluoridation is to prevent tooth decay and dental fluorosis. This condition can change the appearance of the child’s tooth during the tooth development stage. Water fluoridation to 1mg/L causes fluorosis to 1 in 6 people and the fluorosis that is aesthetically concerned is caused 1 in 22 people (Colquhoun J, 1985).
Thyroid: The fluoride suppressive cause on thyroid is more in case iodine is deficient. This effect is related to human when the level of fluoride is 0.05 to 0.13 mg/kg/day and when iodine intake was inadequate.
The workers in the industries when use or manufacture the compounds of fluoride are at a higher risk. Consumers are exposed to fluoride when using the products made fluoride. The residents who live in close to the production processing factories of fluoride compounds are at risk of receiving low levels of fluoride exposure.
Sources of exposure
General Population: The general peoples are exposed via the drinking water, dental products and food. The people living in areas having high fluoride levels in water and the soil are exposed at higher levels of fluoride. People living near the industrial areas which contain hydrogen fluoride like coal burning sites are also at a higher risk of fluoride level which is present in air (Groeneveld A, VanEck AA, et al, 1990). The natural source of fluoride is emission form the volcanoes and the other artificial source is from electrical equipments.
Occupational Population: Higher levels are present in the laborers working in industries manufacturing fluoride containing products, pharmaceuticals, fluroscent bulbs etc.
Mechanism of Exposure
The effect of fluoride is caused by interfering in the demineralization process of the decay of tooth. It is a infectious disease, it starts with increase in the dental plaque of various bacteriums like Lactobacillus, Streptococcus mutans. It leads to production of organic acids upon intake of the carbohydrates from sources like sugar. The large amounts of acid is produced then it lowers the pH value below 5.5. The acid further dissolves the carbonated hydroxyapatite which is a major component of tooth enamel. This process of dissolving is known as demineralization. Upon the reduction of sugar some minerals are recovered from the enzymes of saliva, it is known as remineralization. The cavity formation takes place when the rate of demineralization exceeds remineralization. All these creates low amount of the ions of fluoride in saliva fluid and plaque fluid, this effect is known as the surface effect. An individual consuming fluorinated water has higher concentration of fluoride in his saliva about 0.04mg/l. It controls the development of cavities. Afluropatite remineralized veneer is formed due to presence of fluoride ions in the plaque fluid along with hydroxypatite and also has higher pH 0f 4.5 or more. This veneer is much more resistant then the ordinary remineralized enamel. Thus the cavity formation is prevented by this surface effect. Some of the fluoride ions then return back to the saliva through blood plasma and to unerupted tooth through the plasma fluid. Although the fluordisation process reduces the formation of tooth decay but it does not prevent cavity formation (Kram D, Schneider EL, et al, 1978)
The effects of fluoride depends on the total intake of fluoride from different sources. 70 to 90% is absorbed by the blood stream where it get distributed to various body parts. In case of infants about 80 to 90% fluoride ins are retained in the body rest of them are excreted via the urine. In comparison to infants adults retain fluorides to 60% only. These retained fluoride ions are then further stored into teeth, bones, and others calcium significant areas and if any area the quantity increases then chances of fluorosis may occur(Disney JA, Bohannan HM, et al, 1990).
The most important biomarkers of fluoride exposure are the serum and the urinary fluorides. These measurements are advised to be taken shortly after the fluoride consumption as the levels eliminates rapidly. In many cases the excess of fluoride in the body occurs due to swallowed tooth paste. Other sources of high fluoride levels are cassava, rice, corn, taro, fish protein, yams. The recommended in take level of fluoride is given as follows:
For infant up to 6 months is 0.01 mg/day
For individuals aged 19 or more is 4 mg/
Tolerable Intake Level is 0.10 mg/kg/day for the infants
Tolerable intake level is 10mg/kg/day for children above eight.
Toxicokinetics of fluoride:
About all of the fluorine inhaled in the form of hydrogen fluoride is absorbed by the upper respiratory tracts.
The compounds of fluoride that are soluble are absorbed by the gastro intestinal tracts by about 80 to 100%. The compounds of fluoride that are insoluble are slightly absorbed that is less than 10%.
Skin is responsible for absorbing hydrofluoric acid.
After absorption the fluoride goes to the calcium rich areas.
Metabolisation of fluoride does not takes place instead it is excreted along with urine.
Biotransformation of fluorides
The fluoride absorbed by the body cannot be metabolized but it is capable of forming fluoride phosphate complexes with the metals like aluminum, calcium, magnesium, beryllium etc. Such king of reactions occurring in the gastrointestinal tract reduces the absorption level of fluorides. The inhaled organic fluorides like enflurane, halothane, methoxyflurane are exhaled by breathing. These three are the anesthetics. At these same time some transformations of these compounds of fluoride occurs in the livers and some tissues. The researches have found that the plasma level increases after exposure to these three inorganic fluorides. Amongst the three anesthetics methoxyflurane is the most fat soluble than other two anesthetics, it builds stores in human body and is released at a very slow level. So the methoxyflurane produces high elevation in the plasma fluoride than the other two anesthetics.
Evidences obtained from scientific review
These scientific reviews are important to check the safety of community water fluoridation.
Scientific and other public health organizations studies have conducted the scientific reviews about the fluoridation from the past decades. The reviews provides significant evidences that the fluoridation process us safe, efficient and effective method to reduce the tooth decay.
Review of Government of Australia
Australia 's National Health and Medical Research Council comes up with a review published in 2007 with certain evidences that relate to the safety and efficiency of fluoride. This report is addressed upon the caries reducing the benefits and the health risk due to the low or high levels of fluoride. This review contains the following points:
The community drinking water fluoridation process has been proved beneficial for deterioting the tooth decay.
The optimum and the recommended fluoride does not effects the health.
No evidence has been found out between the relation of cancer and the water fluoridation.
The studies has not found any increased risk of health effects at the recommended levels of
fluoride.
An Australian agency which supports the health and medical researches is NHMRC. This NHMRC has been helping the Australians, government and the health practitioners in their health care and medical researches.
University of York: It released a systemic review of public water fluoridation in the year 2000. It was released by National Health Service centre for reviews and dissemination. It looks both at the pros and corns of the drinking water fluoridation. They laid down their objectives and on their research following things were found out:
The fluoridation process reduces the dental caries.
The process is still effective even when with the use of various sources of the fluorides.
There is no relation between the cancer, bone fracture and fluoridation process.
There are no differences between the natural fluoridation process and artificial fluoridation process.
There were no evidences for the negative effects on health of the individuals.
Misconception of fluoride consumption with cancer
Addition of fluoride is common in many countries. There are websites which say addition of fluoride is responsible for causing cancer, fractures, birth defects, anemia, heart disease and osteosarcoma that is a bone cancer. Many studies show that the fluoride in the body interferes with the normal functioning and genetics of the body and thus further cause diseases.
Current evidences: Fluoride is meant for the calcified tissues that are bone and teeth development in the human body. At the low levels its consumption has shown benefits to prevent tooth decay. In the first decade of water fluoridation in Australia tooth decay was reduced by 60%. At that time this fluoridation process was considered as “Ten Great Public Health Achievements” in the United States by the Centres for Disease Control and Prevention. In Australia about 70% of drinking water is fluorinated. The Australian drinking guidelines are at the level of 0.7 to 1.0 mg/l. The lower level is meant for the areas where the climate is very hot and people consume more amount of water. International Agency for the Research of Cancer has identified the safety of fluorinated drinking water in the year 1982 and the evidences were reviewed in the year 1987. It also says that there is no corelation between cancer and the fluoride consumption. The studies that are published after these reviews has also not shown any clear and significant link between carcinogenicity among humans and cancer. The National Health and Medical Research performed a systemic review consisting of about 5418 citations. Among these citations 11 of them recommends to supply fluorides to water. Other studies were also performed by American National Toxicology which were able to come up with a link between the osteosarcoma in male rats and high levels of fluoridated water. There is no other study which has proved this research. After that the American national cancer institute performed a research and found there was increase in osteosrcoma with age linked and sex linked characters and was different for non fluorinated and fluorinated areas. Further analysis does not show any link between cancer and fluorinated water. So, it was concluded the water fluorination and carcinogenicity are not linked.
Pros and cons of the fluoridation process
The debate over the positive and negative effects of water fluoridation is raged from sometime. Various surveys are done for this by the water companies. They are explained below:
Pros:
The addition of fluoride to the public supply of water has been proved beneficial and is responsible for the decline in dental caries. This is practiced from last 1980s and has proved beneficial for the improvement of the overall individuals health and the protection against tooth cavities also.
American Dental Association has proved that fluoride is completely safe for the human body but if only consumed in the recommended amounts.
This addition is helpful to the people living in areas where there is limited access of the other sources of fluoride like toothpaste.
Cons
It is up to every individual water supplier to add fluoride or not. The environmental protection agency has set a recommended level of 4mg/l to be optimum for the human consumption. The consumption higher then this are harmful for the bones.
But at the recommended level fluoride may cause dental fluorosis, pitting or browning of the tooth in the young ones. Researches show the affect is only on the developing teeth. Approximately 10 to 15% of the young ones who has received the optimum level of fluoride has shown some level of fluorosis. The children who are nine or below nine should intake the fluoride up to 2mg/L.
It is helpful to decrease cavity but some researches show similarity that the dental health in the people who are consuming either fluorinated or non fluorinated water are having a increased dental health. It is a evidence in case of individuals consuming non fluorinated water may receive the fluorine from other sources like toothpaste, products of mouth etc.
The evidences and the literature review suggest that the fluoride intake is good for health. The fluoridation process is beneficial for the bone and tooth health of individuals. The level of fluoride that is recommended proves to be good for adults tooth and bones. But in case of infant sometime problems occur when the children teeths are developing. According to me I would suggest that the water fluoridation process for the drinking water must be carried out by every water supplier but the ions of fluoride must be added in the recommended amount of 4mg/l. As the studies has already shown that there are no harmful effects on the health of individuals when fluoride is taken in consumed amount. But as the fluoride is present in different sources like food, tooth paste and tooth products so it is the duty of the individual to keep a check on the other fluorides sources them are consuming so as to preserve their health. So when consuming fluorinated water one should try to avoid other fluorinated sources. This approach would surely help in the reduction of the tooth decay and at the same time it would also improve the health of the individual. The problem of water fluoridation arises in case of infants who have developing tooth even when the optimum levels are consumed. In this case if a proper check at the tooth development is maintained then the problem can be solved. So according to me the infants must consume the recommended level of fluoride from the fluorinated water but also a check has to be mad regularly of their developing teeth.
Summing up, all these theories and researches suggest that the water fluoridation process must be carried out by every water supplier. It is the duty of the environmental protection agency to keep a check on the levels of fluoride. The government of all the countries should make norms and rules to effectively, safely and efficiently carry out the process of water fluoridation. At the same time the community should also keep a check on the production of fluoride from other sources like industries. If such issues are there then they should be addressed immediately to the government, so that the government can take appropriate measures to protect the community health. Thus, water fluoridation is a safe and efficient process.
References
Colquhoun J, "Influences of Social Class and Fluoridation on Child Dental Health," 1985, Comm Dent Oral Epidemiol 13:37-41.
Disney JA, Bohannan HM, et al., "A Case Study in Contesting the Conventional Wisdom: School-Based Ruoride Mouthrinse Programs in the USA," 1990, Community Dent Oral Epidemiol, 18(1):46-54.
Graves RC and Stamm JW, "Decline in Dental Caries. What Occurred and Will it Continue?," 1985, Can Dent Assoc J, 51(9):693-9.
Groeneveld A, VanEck AA, et al., "Fluoride in Caries Prevention: Is the Effect Pre- or Post-Eruptive?" Feb 1990, J Dent Res, 69(Spec No):751-5; 820-3.
Kram D, Schneider EL, et al., "The Effects of High and Low Fluoride Diets on the Frequencies of Sister Chromatid Exchanges," 1978, Mutat Res 57(1):51-5.
dangerous too. In the below paragraphs a brief description about the fluoridation process, mechanisms, advantages, disadvantages and the detailed research literature are described.
Execution process of fluoride
Fluoridation has no effect on the taste, appearance or the smell of the drinking water. It is implemented by the addition of sodium fluoride or odium fluorosilicate or fluorosilicic acid in the drinking water
Sodium fluoride is the first component that can be added to water and was used in the reference standard. It is white, odourless crystal or in powder form .the crystal form is used when handling manually and it is most expensive than other compounds (Graves RC and Stamm JW, 1985).
Fluorosilicic acid is the most common used compound for fluoride addition. It is inexpensive and it’s a byproduct of manufacture of phosphate fertilizer. It comes in different strengths and it contains a lot of water.
Sodium fluorosilicate is a salt of the fluorosilicic acid. It is in powder or fine crystal form.
All the three compounds are of low cost, soluble, safe and easily available. Fluoride occurs in water at, below or at the recommended level. In the water fluoride exists as F- ions commonly and also exists in combination magnesium as magnesium fluoride. In some cases when the water contains fluoride levels excess than the required then defluoridation is done by percolating the water through the granular beds of bone meal, bone charm activated alumina, or tricalcium phosphate. The reverse osmosis process also removes 60 to 65% of fluoride.
Toxicity of fluoride
The compounds of fluoride enter in the body by the inhalation and ingestion process. The fluoride excess levels can damage various parts and functioning of body. These are described below:
Brain: A meta analysis research shows exposure to high levels of fluoride during childhood may cause reduction in IQ level. Studies are going on to find the adverse effects of fluoride on children neurodevelopment.
Bones: The toxic levels of fluoride shows weakening of the bones and an increase in fractures of hip and wrist. The intake of fluoride beyond the levels of the drinking water for a longer period may cause skeletal fluorosis. In the Asian subcontinent its an endemic disease with symptoms of joint pain and irritable bowels
Kidney: Toxic levels of fluoride also cause kidney injury
Teeth: The purpose of water fluoridation is to prevent tooth decay and dental fluorosis. This condition can change the appearance of the child’s tooth during the tooth development stage. Water fluoridation to 1mg/L causes fluorosis to 1 in 6 people and the fluorosis that is aesthetically concerned is caused 1 in 22 people (Colquhoun J, 1985).
Thyroid: The fluoride suppressive cause on thyroid is more in case iodine is deficient. This effect is related to human when the level of fluoride is 0.05 to 0.13 mg/kg/day and when iodine intake was inadequate.
The workers in the industries when use or manufacture the compounds of fluoride are at a higher risk. Consumers are exposed to fluoride when using the products made fluoride. The residents who live in close to the production processing factories of fluoride compounds are at risk of receiving low levels of fluoride exposure.
Sources of exposure
General Population: The general peoples are exposed via the drinking water, dental products and food. The people living in areas having high fluoride levels in water and the soil are exposed at higher levels of fluoride. People living near the industrial areas which contain hydrogen fluoride like coal burning sites are also at a higher risk of fluoride level which is present in air (Groeneveld A, VanEck AA, et al, 1990). The natural source of fluoride is emission form the volcanoes and the other artificial source is from electrical equipments.
Occupational Population: Higher levels are present in the laborers working in industries manufacturing fluoride containing products, pharmaceuticals, fluroscent bulbs etc.
Mechanism of Exposure
The effect of fluoride is caused by interfering in the demineralization process of the decay of tooth. It is a infectious disease, it starts with increase in the dental plaque of various bacteriums like Lactobacillus, Streptococcus mutans. It leads to production of organic acids upon intake of the carbohydrates from sources like sugar. The large amounts of acid is produced then it lowers the pH value below 5.5. The acid further dissolves the carbonated hydroxyapatite which is a major component of tooth enamel. This process of dissolving is known as demineralization. Upon the reduction of sugar some minerals are recovered from the enzymes of saliva, it is known as remineralization. The cavity formation takes place when the rate of demineralization exceeds remineralization. All these creates low amount of the ions of fluoride in saliva fluid and plaque fluid, this effect is known as the surface effect. An individual consuming fluorinated water has higher concentration of fluoride in his saliva about 0.04mg/l. It controls the development of cavities. Afluropatite remineralized veneer is formed due to presence of fluoride ions in the plaque fluid along with hydroxypatite and also has higher pH 0f 4.5 or more. This veneer is much more resistant then the ordinary remineralized enamel. Thus the cavity formation is prevented by this surface effect. Some of the fluoride ions then return back to the saliva through blood plasma and to unerupted tooth through the plasma fluid. Although the fluordisation process reduces the formation of tooth decay but it does not prevent cavity formation (Kram D, Schneider EL, et al, 1978)
The effects of fluoride depends on the total intake of fluoride from different sources. 70 to 90% is absorbed by the blood stream where it get distributed to various body parts. In case of infants about 80 to 90% fluoride ins are retained in the body rest of them are excreted via the urine. In comparison to infants adults retain fluorides to 60% only. These retained fluoride ions are then further stored into teeth, bones, and others calcium significant areas and if any area the quantity increases then chances of fluorosis may occur(Disney JA, Bohannan HM, et al, 1990).
The most important biomarkers of fluoride exposure are the serum and the urinary fluorides. These measurements are advised to be taken shortly after the fluoride consumption as the levels eliminates rapidly. In many cases the excess of fluoride in the body occurs due to swallowed tooth paste. Other sources of high fluoride levels are cassava, rice, corn, taro, fish protein, yams. The recommended in take level of fluoride is given as follows:
For infant up to 6 months is 0.01 mg/day
For individuals aged 19 or more is 4 mg/
Tolerable Intake Level is 0.10 mg/kg/day for the infants
Tolerable intake level is 10mg/kg/day for children above eight.
Toxicokinetics of fluoride:
About all of the fluorine inhaled in the form of hydrogen fluoride is absorbed by the upper respiratory tracts.
The compounds of fluoride that are soluble are absorbed by the gastro intestinal tracts by about 80 to 100%. The compounds of fluoride that are insoluble are slightly absorbed that is less than 10%.
Skin is responsible for absorbing hydrofluoric acid.
After absorption the fluoride goes to the calcium rich areas.
Metabolisation of fluoride does not takes place instead it is excreted along with urine.
Biotransformation of fluorides
The fluoride absorbed by the body cannot be metabolized but it is capable of forming fluoride phosphate complexes with the metals like aluminum, calcium, magnesium, beryllium etc. Such king of reactions occurring in the gastrointestinal tract reduces the absorption level of fluorides. The inhaled organic fluorides like enflurane, halothane, methoxyflurane are exhaled by breathing. These three are the anesthetics. At these same time some transformations of these compounds of fluoride occurs in the livers and some tissues. The researches have found that the plasma level increases after exposure to these three inorganic fluorides. Amongst the three anesthetics methoxyflurane is the most fat soluble than other two anesthetics, it builds stores in human body and is released at a very slow level. So the methoxyflurane produces high elevation in the plasma fluoride than the other two anesthetics.
Evidences obtained from scientific review
These scientific reviews are important to check the safety of community water fluoridation.
Scientific and other public health organizations studies have conducted the scientific reviews about the fluoridation from the past decades. The reviews provides significant evidences that the fluoridation process us safe, efficient and effective method to reduce the tooth decay.
Review of Government of Australia
Australia 's National Health and Medical Research Council comes up with a review published in 2007 with certain evidences that relate to the safety and efficiency of fluoride. This report is addressed upon the caries reducing the benefits and the health risk due to the low or high levels of fluoride. This review contains the following points:
The community drinking water fluoridation process has been proved beneficial for deterioting the tooth decay.
The optimum and the recommended fluoride does not effects the health.
No evidence has been found out between the relation of cancer and the water fluoridation.
The studies has not found any increased risk of health effects at the recommended levels of
fluoride.
An Australian agency which supports the health and medical researches is NHMRC. This NHMRC has been helping the Australians, government and the health practitioners in their health care and medical researches.
University of York: It released a systemic review of public water fluoridation in the year 2000. It was released by National Health Service centre for reviews and dissemination. It looks both at the pros and corns of the drinking water fluoridation. They laid down their objectives and on their research following things were found out:
The fluoridation process reduces the dental caries.
The process is still effective even when with the use of various sources of the fluorides.
There is no relation between the cancer, bone fracture and fluoridation process.
There are no differences between the natural fluoridation process and artificial fluoridation process.
There were no evidences for the negative effects on health of the individuals.
Misconception of fluoride consumption with cancer
Addition of fluoride is common in many countries. There are websites which say addition of fluoride is responsible for causing cancer, fractures, birth defects, anemia, heart disease and osteosarcoma that is a bone cancer. Many studies show that the fluoride in the body interferes with the normal functioning and genetics of the body and thus further cause diseases.
Current evidences: Fluoride is meant for the calcified tissues that are bone and teeth development in the human body. At the low levels its consumption has shown benefits to prevent tooth decay. In the first decade of water fluoridation in Australia tooth decay was reduced by 60%. At that time this fluoridation process was considered as “Ten Great Public Health Achievements” in the United States by the Centres for Disease Control and Prevention. In Australia about 70% of drinking water is fluorinated. The Australian drinking guidelines are at the level of 0.7 to 1.0 mg/l. The lower level is meant for the areas where the climate is very hot and people consume more amount of water. International Agency for the Research of Cancer has identified the safety of fluorinated drinking water in the year 1982 and the evidences were reviewed in the year 1987. It also says that there is no corelation between cancer and the fluoride consumption. The studies that are published after these reviews has also not shown any clear and significant link between carcinogenicity among humans and cancer. The National Health and Medical Research performed a systemic review consisting of about 5418 citations. Among these citations 11 of them recommends to supply fluorides to water. Other studies were also performed by American National Toxicology which were able to come up with a link between the osteosarcoma in male rats and high levels of fluoridated water. There is no other study which has proved this research. After that the American national cancer institute performed a research and found there was increase in osteosrcoma with age linked and sex linked characters and was different for non fluorinated and fluorinated areas. Further analysis does not show any link between cancer and fluorinated water. So, it was concluded the water fluorination and carcinogenicity are not linked.
Pros and cons of the fluoridation process
The debate over the positive and negative effects of water fluoridation is raged from sometime. Various surveys are done for this by the water companies. They are explained below:
Pros:
The addition of fluoride to the public supply of water has been proved beneficial and is responsible for the decline in dental caries. This is practiced from last 1980s and has proved beneficial for the improvement of the overall individuals health and the protection against tooth cavities also.
American Dental Association has proved that fluoride is completely safe for the human body but if only consumed in the recommended amounts.
This addition is helpful to the people living in areas where there is limited access of the other sources of fluoride like toothpaste.
Cons
It is up to every individual water supplier to add fluoride or not. The environmental protection agency has set a recommended level of 4mg/l to be optimum for the human consumption. The consumption higher then this are harmful for the bones.
But at the recommended level fluoride may cause dental fluorosis, pitting or browning of the tooth in the young ones. Researches show the affect is only on the developing teeth. Approximately 10 to 15% of the young ones who has received the optimum level of fluoride has shown some level of fluorosis. The children who are nine or below nine should intake the fluoride up to 2mg/L.
It is helpful to decrease cavity but some researches show similarity that the dental health in the people who are consuming either fluorinated or non fluorinated water are having a increased dental health. It is a evidence in case of individuals consuming non fluorinated water may receive the fluorine from other sources like toothpaste, products of mouth etc.
The evidences and the literature review suggest that the fluoride intake is good for health. The fluoridation process is beneficial for the bone and tooth health of individuals. The level of fluoride that is recommended proves to be good for adults tooth and bones. But in case of infant sometime problems occur when the children teeths are developing. According to me I would suggest that the water fluoridation process for the drinking water must be carried out by every water supplier but the ions of fluoride must be added in the recommended amount of 4mg/l. As the studies has already shown that there are no harmful effects on the health of individuals when fluoride is taken in consumed amount. But as the fluoride is present in different sources like food, tooth paste and tooth products so it is the duty of the individual to keep a check on the other fluorides sources them are consuming so as to preserve their health. So when consuming fluorinated water one should try to avoid other fluorinated sources. This approach would surely help in the reduction of the tooth decay and at the same time it would also improve the health of the individual. The problem of water fluoridation arises in case of infants who have developing tooth even when the optimum levels are consumed. In this case if a proper check at the tooth development is maintained then the problem can be solved. So according to me the infants must consume the recommended level of fluoride from the fluorinated water but also a check has to be mad regularly of their developing teeth.
Summing up, all these theories and researches suggest that the water fluoridation process must be carried out by every water supplier. It is the duty of the environmental protection agency to keep a check on the levels of fluoride. The government of all the countries should make norms and rules to effectively, safely and efficiently carry out the process of water fluoridation. At the same time the community should also keep a check on the production of fluoride from other sources like industries. If such issues are there then they should be addressed immediately to the government, so that the government can take appropriate measures to protect the community health. Thus, water fluoridation is a safe and efficient process.
References
Colquhoun J, "Influences of Social Class and Fluoridation on Child Dental Health," 1985, Comm Dent Oral Epidemiol 13:37-41.
Disney JA, Bohannan HM, et al., "A Case Study in Contesting the Conventional Wisdom: School-Based Ruoride Mouthrinse Programs in the USA," 1990, Community Dent Oral Epidemiol, 18(1):46-54.
Graves RC and Stamm JW, "Decline in Dental Caries. What Occurred and Will it Continue?," 1985, Can Dent Assoc J, 51(9):693-9.
Groeneveld A, VanEck AA, et al., "Fluoride in Caries Prevention: Is the Effect Pre- or Post-Eruptive?" Feb 1990, J Dent Res, 69(Spec No):751-5; 820-3.
Kram D, Schneider EL, et al., "The Effects of High and Low Fluoride Diets on the Frequencies of Sister Chromatid Exchanges," 1978, Mutat Res 57(1):51-5.