Public Policy l Fluoridation Facts 109 of fluoridation can be challenging partially because the beneficial effect is not immediately apparent.12 Cost savings from fluoridation would be expected to increase over several years’ time. The most notable decrease in tooth decay would be anticipated in young children who received the benefits of fluoridation over their lifetime in both their primary teeth and as their adult teeth begin to appear when the children are approximately six years old. More immediate savings could be realized in recently fluoridated communities as children who had once received fluoride supplements would no longer require these prescriptions which are typically recommended for children from six months to 16 years of age, whose primary drinking water source is not fluoridated and have been determined to be at high risk for tooth decay. Benefits from the prevention of tooth decay can include: • freedom from dental pain • a more positive self-image • fewer missing teeth • fewer cases of poorly aligned tooth aggravated by tooth loss • fewer teeth requiring root canal treatment • reduced need for crown, bridges, dentures and implants • less time lost from school or work because of dental pain or visits to the dentist While some of these types of benefits are difficult to measure economically, they are extremely important.13,14 Fluoridation remains the most cost-effective and practical form of preventing tooth decay in the United States and other countries with established municipal water systems. It is one of the very few public health measures that actually saves more money than it costs.13,15-17 69. Why fluoridate an entire water system when the vast majority of the water is not used for drinking? Answer. It is more practical and less costly to fluoridate an entire water supply than to attempt to treat only the water that will be consumed. Fact. Water systems treat all the water supplied to communities to the same high standards, for disinfection, clarity or fluoridation, whether the water is to be used for washing dishes, washing a car, watering lawns, preparing food or drinking. Although not all that water needs to be disinfected, clarified or fluoridated, it is more practical and cost efficient to treat all the water delivered to the customer to the same standard. Fluoride is only one of more than 40 different chemicals/additives that can be used to treat water in the United States. Many are added for aesthetic or convenience purposes such as to improve the odor or taste, prevent natural cloudiness or prevent staining of clothes or porcelain.18 The cost of additives for fluoridating a community’s water supply is very low on a per capita basis therefore, it is practical to fluoridate the entire water supply. It would be prohibitively expensive and impractical for a community to have two water systems — one that provided drinking water and another for all other water use (watering lawns, laundry, flushing toilets). Many organizations that are concerned about water use, conservation and quality support the practice of water fluoridation. For example, the American Water Works Association, an international nonprofit scientific and educational association dedicated to the improvement of drinking water quality and supply, supports the practice of fluoridation of public water supplies.19