The U.S. Centers for Disease Control and Prevention (CDC) considers the fluoridation of water to be one of the great public health achievements of the 20th century. By the early ‘50s, fluoridation became an official policy of the U.S. Public Health Service. In less than 10 years, water fluoridation became widely used in the United States, reaching about 50 million people. By 2006, almost 70 percent of the U.S. population on public water systems was receiving fluoridated water.
The goal of water fluoridation is to prevent tooth decay. Dental cavities remain a major public health concern in most industrialized countries, affecting up to 90 percent of schoolchildren and the vast majority of adults. Studies have shown that water fluoridation prevents cavities in both children and adults. Fluoridation does not affect the appearance, taste or smell of drinking water, and is normally accomplished by adding one of three compounds to the water: sodium fluoride, hydrofluorosilicic acid or sodium fluorosilicate.
In Austin, fluoridation has been included in the water treatment process for nearly four decades. It’s a requirement that’s on the books as ordinance No. 720817-11, which is based on a 1972 public referendum. Austin Water uses hydrofluorosilicic acid, an inexpensive liquid by-product of phosphate fertilizer production, to fluoridate during its water treatment process. Before the hydrofluorosilicic acid is purchased, it must meet all the American Water Works Association (AWWA) specifications, and be National Sanitation Foundation (NSF) 60 certified.
The use of fluoride in public water systems is heavily regulated by a variety of agencies, including the NSF, which has created the NSF Standard 60 Certification. NSF 60 establishes purity standards for chemicals used in drinking water, as well as maximum dosages allowed for all certified chemicals used in the water treatment process. The NSF also performs rigorous reviews and testing before it certifies any treatment facility.
Austin Water supplements the naturally occurring levels of fluoride in the water. The optimal range set by the CDC is 0.7 mg/l- 1.2 mg/l based on the average annual temperatures of the city being served. Austin Water, due to our warmer climate, maintains fluoridation levels near 0.7 mg/l. This level is well below the Environmental Protection Agency maximum limit of 4.0 mg/l, which is established to protect against any adverse health effects, along with a secondary standard of 2.0 mg/l that protects against aesthetic issues such as mottling of teeth.
The American Dental Association (ADA) has endorsed fluoridation of community water supplies as safe and effective for preventing tooth decay since 1950. The ADA suggests that water fluoridation is also cost-effective, and that fluoridation costs are about 50 cents a year per person in large communities to nearly $3 a year per person in smaller areas. For most cities, it’s estimated that every dollar invested in water fluoridation saves $38 in dental treatment costs.
But this seemingly well-studied, documented and supported public health benefit does not come without controversy. Opponents believe fluoridation can be viewed as a violation of ethical or legal rules that prohibit medical treatment without medical supervision or informed consent. Others claim fluoridation is not cost-effective, and is difficult to control, which results in a serious threat to public health. There are also conspiracy theories rooted in water fluoridation, including the claim that it is a communistic plot to somehow poison the American people.
The water fluoridation debate continues around the world and right here in the Capitol City. Austin Water is committed to following the established will of the people set back in 1972. The city-owned utility is vigilant in abiding by the fluoridation protocols that ensure the safety and quality of the community’s drinking water.
If there are questions or concerns about water fluoridation from the public, health experts or elected officials, the issue of water fluoridation could make its way back to the ballot box. For now, however, the benefits have outweighed any ethical, legal and public health concerns.
For more information on water fluoridation for Austin, visit http://www.ci.austin.tx.us/water/fluoride.htm.
