Drinking Water Fluoridation

By Ron Duffin, DDS

What is fluoride?

Fluoride exists naturally in water sources and is derived from fluorine, the thirteenth most common element in the Earth’s crust.  It is well known that fluoride helps prevent and even reverses the early stages of tooth decay. Fluoride combats tooth decay in two ways.  It strengthens tooth enamel, the hard shiny substance that protects the teeth, so they can resist tooth decay. Fluoride cannot repair cavities, but it can reverse low levels of tooth decay and thus prevent new cavities from forming.

How much fluoride is available through public water systems?

Eastern Municipal Water District announced that it increased its fluoride levels from the current level of 0.1 –0.4ppm up to 0.7-0.8ppm last October, as recommended by the California Department of Public Health. EMWD provides water to a large portion of Riverside County residents.  They are increasing the fluoride levels in the Hemet/ San Jacinto Valley summer of 2008.  The American Dental Association is a strong supporter of community water fluoridation, and has stated that this is one of the 10 great public health achievements of the 20th century, and as a safe, beneficial and cost-effective way to prevent tooth decay in children and adults.

How much fluoride is enough?

It depends on the age of the patient, and the amount of water ingested.  Fluoride is not recommended for infants under 6 months.  Children should use a pea size amount of toothpaste containing fluoride on their toothbrush after age three. The California Department of Public Health recommends suspending the use of prescription fluoride (ingested) for one year in areas where fluoridation programs have just begun.  This does not include the topical fluoride applications used in the dental office.  For a complete list of fluoride levels in public water systems, please refer to the California Department of Public Health Web site @ www.cdhp.ca.gov.

The following supplement dosage schedule has been approved by the ADA:

Age                                         Fluorine             ION Level in Drinking Water       ppm

                                               <0.3 ppm            0.3-0.6ppm                                    <0.6ppm______
Birth – 6 months                  None                   None                                               None
6 months- 3 years               0.25mg/day        None                                               None              
3-6 years                               0.50mg/day       0.25mg/day                                    None
6-16 years                             1.0mg/day         0.50mg/day                                    None

1.0ppm = 1mg/liter
**2.2mg sodium fluoride contains 1mg fluoride ion

What happens when your child receives too much fluoride?

Too much fluoride before 8 years of age can cause enamel fluorosis, a discoloration or mottling of the permanent teeth.  This condition is unsightly but harmless and often can be treated with cosmetic procedures.

If you have questions regarding your area’s water fluoride content, the fluoride products your child uses or whether you child is receiving too much or too little fluoride talk to your child’s doctor or dentist.

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