community water fluoridation 060112

Should my child continue

taking fluoride supplements?

If your child

drinks from a

community

water supply or

private home

well, which has

been tested and

found to have sufficient levels of fluoride,

then the Maryland Department of Health

and Mental Hygiene does not recommend

taking prescription fluoride supplements.

If you do not know the concentration of

fluoride in your water, it is important to

contact your local health department and/

or have it tested, before taking any fluoride

supplements. Consult your medical or

dental provider before making any

decisions.

Fluoride is a natural element found in

rocks and soil, in fresh water, and in ocean

water. Waters in and around the United

States have natural fluoride levels that

range from 0.1 to more than 12 parts per

million (ppm). One ppm is like one cent in

$10,000.00. The optimal fluoride level for

a community water system is 0.7ppm.

What is fluoride?

What are the benefits of water

fluoridation?

Health experts endorse water fluoridation

as the single, most effective public health

measure to improve oral health.

Fluoridation:

 Prevents tooth decay.

 Strengthens tooth enamel.

 Kills germs that cause tooth decay.

 Is a cost effective means of improving

community health.

Community water fluoridation is simply

adding enough fluoride to the natural level

of fluoride in the water to reach the

recommended level for preventing tooth

decay.

Should my family continue

brushing with fluoride toothpaste?

Yes. Fluoridated

water is part of a

total oral health

program which is a

community driven

public health

benefit. You also

get protection from

germs that cause

cavities when you

brush with

fluoridated

toothpaste at least

twice a day for two

minutes and floss

every day.

Make sure your children minimize their

risk of swallowing toothpaste by controlling

the amount of toothpaste present on the

toothbrush.

Toothbrush images under license

from the Calgary Health Region™.

How Much Toothpaste

with Fluoride?

Under Age 2:

Slight smear the size

of a grain of rice

Under Age 3-5:

1/2 of pea-size

It is best to spit and

not rinse after brushing.

Age 6+: pea-size

The City of Baltimore began water

fluoridation in 1952. Currently, in the State

of Maryland, 93.1% of the population served

by community water systems (more than 4.5

million people) receives fluoridated water.

All drinking water additives (including

fluoride) are required by state law to be

tested for purity and certified safe,

regardless of where they are manufactured.

FLUORIDE FACTSFLUORIDE FACTS

Does bottled water

contain fluoride?

The U.S. Food and Drug

Administration (FDA) does not

require bottlers to list the

fluoride concentration (how

many ppm) in a bottle of water unless the

bottler adds additional fluoride.

Children who drink filtered water

(from filter pitchers, faucet filters,

refrigerator filters, etc.) may not

be receiving adequate dietary fluoride and

may require fluoride supplements. Consult

the filter manufacturer and your medical

or dental provider before making any

decisions.

WHICH WATER FILTER

SYSTEMS REMOVE FLUORIDE ?

TYPE OF FILTER

YSTEM

EFFECT ON

LUORIDE

Activated Carbon

Filter (the majority

of home faucet and

pitcher filters,

including Brita and

PUR filters)

Doesnot

typicallyremove

ﬂuoride(CDC,

2008)

ActivatedCarbon

ﬁlterw/activated

alumina

Removesover

80%ofﬂuoride

WaterSoftener

Doesnotremove

ﬂuoride

CharcoalFilter

Doesnotremove

ﬂuoride

ReverseOsmosis

Removesupto

95%ofﬂuoride

WaterDistillation

Removes100%

ofﬂuoride

*Adapted from: American Dental Association "Home

Water Treatment Systems" 2010-03-23.

Does my sink water filter

remove fluoride from water?

Who supports water fluoridation?

Virtually all major national and international

health, service and professional organizations

endorse or support water fluoridation,

including the following:

American Dental Association

American Medical Association

American Academy of Pediatrics

American Academy of Pediatric Dentistry

US Public Health Service

Centers for Disease Control and

Prevention

World Health Organization

National Academy of Sciences

American Water Works Association

Maryland Department of Health and

Mental Hygiene

Maryland Department of the Environment

As with other nutrients, fluoride

is safe and effective when used

and consumed properly.

What Does Water Fluoridation Cost?

The average cost for a community to fluoridate its water

ranges from $0.62 a year per person in large communities to

$3.90 a year per person in small communities (2004 dollars).

Over a lifetime, this is typically less than the cost of one dental

filling to repair one decayed tooth.

Remember, when it comes to the costs of treating dental disease, everyone pays.

Not just those who need treatment, but all of us—through higher health insurance

premiums and higher taxes.

For most cities, every $1 invested in community water fluoridation saves $38 in

dental treatment costs. Through fluoridation, communities can improve the oral

health of their residents and save money for all of us.

More than 50 years of evidence supports the

effectiveness of fluoridated water and its ability

to prevent, reduce, or even reverse the onset

and development of tooth decay.

Approximately 184 million Americans drink fluoridated water. Community

fluoridated water systems are present in 60 other countries. Through continuous

research, drinking optimally fluoridated water has been scientifically proven to be safe,

not toxic, and effective.

The addition of supplemental fluoride to drinking water can

be compared to the addition of supplemental Vitamin D to

milk.

 Both fluoride and vitamin D occur naturally and

provide significant health benefits when present in a

person’s diet at sufficient levels.

 Sufficient levels of Vitamin D in a person’s diet can

prevent rickets in children and bone disease in adults.

Sufficient levels of fluoride in a person’s drinking water

can reduce tooth decay and strengthen tooth enamel.

Is Community Water

Fluoridation Safe?

“The fluoridation of drinking water to

prevent dental decay is recognized as

one of 10 great public health

achievements of the 20th century.”

Centers for Disease Control

and Prevention

“Community water fluoridation continues

to be the most cost-effective, equitable

and safe means to provide protection

from tooth decay in a community.”

U.S. Surgeon General,

Vice Admiral Richard Carmona,

M.D., M.P.H., F.A.C.S., 2004

“Since 1950, the ADA has unreservedly

endorsed the fluoridation of community

water supplies as safe, effective, and

necessary in preventing tooth decay.“

American Dental Association

COMMUNITY

WATER

FLUORIDATION

MARYLAND

Visit the following web sites for more

information on community water

fluoridation:

Where can I learn more?

www.who.int

www.cdc.gov

American Dental

Association

Centers for Disease

Control and Prevention

www.ada.org



World Health

Organization

Office of Oral Health

Maryland Department of

Health and Mental Hygiene

201 W. Preston Street, 3rd Floor Baltimore,

MD 21201

(410) 767-5300

dhmh.oralhealth@maryland.gov

http://phpa.dhmh.maryland.gov/oralhealth/

Larry Hogan, Governor

Rutherford Boyd, Lieutenant Governor

Van Mitchell, Secretary

The services and facilities of the Maryland Department of Health

and Mental Hygiene (DHMH) are operated on a

nondiscriminatory basis. This policy prohibits discrimination on

the basis of race, color, sex, or national origin and applies to the

provisions of employment and granting of advantages, privileges

and accommodations.

The Department, in compliance with the Americans with

Disabilities Act, ensures that qualified individuals with disabilities

are given an opportunity to participate in and benefit from DHMH

services, benefits, and employment opportunities.

2016