Benefits l Fluoridation Facts 17 It has been observed that the major features of human fluoride metabolism are not affected by the three fluoride additives used in community water fluoridation nor are they affected by whether the fluoride is present naturally or added to drinking water.26 In more simple terms, there is no difference chemically between natural and adjusted fluoridation. When fluoride is added under controlled conditions to fluoride-deficient water, the dental benefits are the same as those obtained from naturally fluoridated water. Fluoridation is merely an increase of the level of the naturally occurring fluoride present in all drinking water sources to the level recommended for optimal dental health. Fluoridation is merely an increase of the level of the naturally occurring fluoride present in all drinking water sources to the level recommended for optimal dental health. For example, a fluoridation study conducted in the Ontario, Canada, communities of Brantford (optimally fluoridated by adjustment), Stratford (optimally fluoridated naturally) and Sarnia (fluoride-deficient), revealed much lower decay rates in both Brantford and Stratford as compared to nonfluoridated Sarnia. There was no observable difference in the decay- reducing effect between the naturally occurring fluoride and adjusted fluoride concentration water supplies, proving that dental benefits were similar regardless of the source of fluoride.27 Some individuals use the term “artificial fluoridation” to imply that the process of water fluoridation is unnatural and that it delivers a foreign substance into a water supply when, in fact, all water sources contain some fluoride. The fluoride ion released in water is the same regardless of the source25 and is metabolized (processed) by the body in the same way no matter what the source.26 Community water fluoridation is a natural way to improve oral health. 7. Is water fluoridation effective in helping to prevent tooth decay? Answer. Yes. According to the best available scientific evidence, community water fluoridation is an effective public health measure for preventing, and in some cases, reversing tooth decay, in children, adolescents and adults. With hundreds of studies published in peer- reviewed, scientific journals, fluoridation is one of the most studied public health measures in history and it continues to be studied today. Fact. The effectiveness of fluoride in drinking water to prevent tooth decay has been documented in the scientific literature for over 70 years. Before the first community fluoridation program began in 1945, epidemiologic data from the 1930s and 1940s were collected and analyzed.28-30 What began as research to learn what caused “Colorado Brown Stain” (dental fluorosis) led to the discovery of strikingly low tooth decay rates associated with fluoride in drinking water at approximately 1 ppm (mg/L). Figure 2 shows the results of early research by Dr. H. Trendley Dean noting the relationship between children’s experience with tooth decay (solid line), dental fluorosis (dotted line) and the fluoride concentration in drinking water.28,29 Additional information on this topic can be found in the Introduction Section. Figure 2. Dean’s Graph Relationships of tooth decay experience (solid line), dental fluorosis index (dashed line) and the fluoride concentration of drinking water.28,29 Caries Experience per Child Fluorosis Index Fluoride Concentration in Water (ppm)