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84 American Dental Association 43. Centers for Disease Control and Prevention. Engineering and administrative recommendations for water fluoridation, 1995. MMWR 1995 44(No.RR-13). Available at: https://www.cdc.gov/mmwr/preview/ mmwrhtml/00039178.htm. Accessed October 2, 2017. 44. American Water Works Association. Internal corrosion control in water distribution systems. AWWA Manual M58. Second edition. Denver. 2017. 45. Federal Register 1998 Aug 19 53(160):44512-36. Available at: https://www.federalregister.gov/documents/1998/08/19/98-22056/ national-primary-drinking-water-reguations-consumer-confidence- reports. Accessed September 20, 2017. 46. U.S. Environmental Protection Agency. Drinking Water Requirements for States and Public Water Systems. Optimal corrosion control treatment evaluation technical recommendations. 2016. Available at: https://www. epa.gov/dwreginfo/optimal-corrosion-control-treatment-evaluation- technical-recommendations. Accessed September 20, 2017. 47. Edmunds WM, Smedley PL. Fluoride in natural waters. In Selinus O. (ed): Essentials of Medical Geology, Revised Edition. Netherlands, Springer. 2013:311-336. 48. Pollick PF. Water fluoridation and the environment: current perspective in the United States. Int J Occup Environ Health 2004 10(3):343- 50. Abstract at: https://www.ncbi.nlm.nih.gov/pubmed/15473093. Accessed on September 20, 2017. 49. Osterman JW. Evaluating the impact of municipal water fluoridation on the aquatic environment. Am J Public Health 1990 80(10):1230-5. Article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1404812. Accessed on September 20, 2017. 50. Tacoma-Pierce County Health Department. Tacoma-Pierce County Health Department fluoridation resolution. WAC197-11-960 environmental checklist. August 2002. Fluoridation Practice References

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84 American Dental Association 43. Centers for Disease Control and Prevention. Engineering and administrative recommendations for water fluoridation, 1995. MMWR 1995 44(No.RR-13). Available at: https://www.cdc.gov/mmwr/preview/ mmwrhtml/00039178.htm. Accessed October 2, 2017. 44. American Water Works Association. Internal corrosion control in water distribution systems. AWWA Manual M58. Second edition. Denver. 2017. 45. Federal Register 1998 Aug 19 53(160):44512-36. Available at: https://www.federalregister.gov/documents/1998/08/19/98-22056/ national-primary-drinking-water-reguations-consumer-confidence- reports. Accessed September 20, 2017. 46. U.S. Environmental Protection Agency. Drinking Water Requirements for States and Public Water Systems. Optimal corrosion control treatment evaluation technical recommendations. 2016. Available at: https://www. epa.gov/dwreginfo/optimal-corrosion-control-treatment-evaluation- technical-recommendations. Accessed September 20, 2017. 47. Edmunds WM, Smedley PL. Fluoride in natural waters. In Selinus O. (ed): Essentials of Medical Geology, Revised Edition. Netherlands, Springer. 2013:311-336. 48. Pollick PF. Water fluoridation and the environment: current perspective in the United States. Int J Occup Environ Health 2004 10(3):343- 50. Abstract at: https://www.ncbi.nlm.nih.gov/pubmed/15473093. Accessed on September 20, 2017. 49. Osterman JW. Evaluating the impact of municipal water fluoridation on the aquatic environment. Am J Public Health 1990 80(10):1230-5. Article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1404812. Accessed on September 20, 2017. 50. Tacoma-Pierce County Health Department. Tacoma-Pierce County Health Department fluoridation resolution. WAC197-11-960 environmental checklist. August 2002. Fluoridation Practice References

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Public Policy l Fluoridation Facts 85 Public Policy 57. What is public health?. ..........................................85 58. Valuable measure?................................................86 59. Reduce disparities?...............................................88 60. Support for fluoridation?.....................................89 61. Courts of law?.......................................................91 62. Opposition?............................................................92 63. Opposition tactics?...............................................93 64. Internet?.................................................................96 65. Public votes?..........................................................97 66. International fluoridation?................................ 101 67. Banned in Europe?. ..............................................102 57. What is public health? Answer. Public health promotes and protects the health of people and the communities where they live, learn, work and play. Public health measures improve the quality of life for members of the community. Fact. Public health has numerous definitions and dimensions. It can encompass issues of research, education, regulation, policy and more. It focuses on the health of entire populations that can vary in size from as small as a local neighborhood to a small-sized community and a large-sized city. It also can focus on populations with a state, national or even global perspective. But how does public health affect our everyday lives? Individuals are touched by public health measures every day without giving them a second thought. For example, garbage pick- up and disposal prevent the spread of disease. The stoplight at a busy intersection protects motorists and pedestrians from injury. Building sidewalks in communities provides the option for people to walk to help control their weight and improve their heart health. Smoke-free laws help prevent lung cancer. All of these are public health in action. Community water fluoridation is another example of a public health measure. • Optimally fluoridated water is accessible to the entire community regardless of socioeconomic status, educational attainment or other social variables.1 • Individuals do not need to take special action or otherwise change their behavior to obtain the benefits of fluoridation. • Frequent exposure to small amounts of fluoride over time makes fluoridation effective through the life span in helping to prevent tooth decay.2 • Community water fluoridation is more cost- effective and cost-saving than other forms of fluoride treatments or applications.3, 4 During the 20th century, the health and life expectancy of persons residing in the United States improved dramatically. Since 1900, the average life span of persons in the United States lengthened by greater than 30 years 25 years of this gain are attributable to advances in public health. Many notable public health achievements occurred during the 1900s. In a series of reports during 1999, the Morbidity and Mortality Weekly Report (MMWR) profiled 10 public health achievements chosen to highlight the contributions of public health and to describe the impact of these contributions on the health and well being of persons in the United States.5 Ten Great Public Health Achievements — United States, 1900-19995 • Vaccination • Motor-vehicle safety • Safer workplaces • Control of infectious diseases • Decline in deaths from coronary heart disease and stroke • Safer and healthier foods • Healthier mothers and babies • Family planning • Fluoridation of drinking water • Recognition of tobacco use as a health hazard

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Fluoridation Practice l Fluoridation Facts 83 1. U.S. Environmental Protection Agency. Overview of the safe drinking water act. 2015. Available at: https://www.epa.gov/sdwa/overview-safe- drinking-water-act. Accessed September 19, 2017. 2. Federal Register 1979 Jul 20 44(141):42775-8. National Archives and Records Administration. Library of Congress. Available at: https://www. loc.gov/item/fr044141. Accessed October 3, 2017. 3. U.S. Department of Health and Human Services. U.S. Food and Drug Administration. Health claim notification for fluoridated water and reduced risk of dental caries. Available at: https://www.fda.gov/food/ labelingnutrition/ucm073602.htm. Accessed September 19, 2017. 4. American Water Works Association. Water fluoridation principles and practices. AWWA Manual M4. Sixth edition. Denver. 2016. 5. American Water Works Association. About us. Available at: https://www. awwa.org/about-us.aspx. Accessed September 20, 2017. 6. NSF International. The public health and safety organization. Available at: http://www.nsf.org. Accessed September 20, 2017. 7. ANSI. American National Standards Institute. About us. Available at: https://www.ansi.org/about_ansi/overview/overview?menuid=1. Accessed September 20, 2017. 8. U.S. Department of Health and Human Services, Centers for Disease Control, Dental Disease Prevention Activity, Center for Prevention Activity. Water fluoridation: a manual for engineers and technicians. Atlanta. 1986. Available at: https://stacks.cdc.gov/view/cdc/13103. Accessed October 2, 2017. 9. Centers for Disease Control and Promotion. Water fluoridation additives. Available at: https://www.cdc.gov/fluoridation/engineering/wfadditives. htm. Accessed September 20, 2107. 10. Duchon K. National. Fluoridation Engineer. Centers for Disease Control and Prevention. Personal communication. CDC WFRS database query. August 24, 2017. 11. NSF International. NSF fact sheet on fluoridation products. Available at: http://www.nsf.org/newsroom_pdf/NSF_Fact_Sheet_on_Fluoridation. pdf. Accessed September 20, 2017. 12. Master RD, Coplan MJ. Water treatment with silicofluoride and lead toxicity. Int J Environ Studies1999 56:435-49. 13. Urbansky ET, Schock MR. Can fluoridation affect lead(II) in potable water? Hexafluorosilicate and fluoride equilibria in aqueous solution. Int J Environ Studies 2000 57:597-637. 14. Finney WF, Wilson E, Callender A, Morris MD, Beck LW. Reexamination of hexafluorosilicate hydrolysis by fluoride NMR and pH measurement. Environ Sci Technol 2006 40(8):2572-7. Abstract at: https://www.ncbi. nlm.nih.gov/pubmed/16683594. Accessed September 21, 2017. 15. Maier FJ. Manual of water fluoridation practice. New York: McGraw-Hill Book Company, Inc. 1963. 16. DeEds F, Thomas JO. Comparative chronic toxicities of fluorine compounds. Proc Soc Exper Biol and Med 1933-34 31:824-5. 17. McClure FJ. A review of fluorine and its physiological effects. Phys Reviews 1933 13:277-300. 18. McClure FJ. Availability of fluorine in sodium fluoride vs. sodium fluosilicate. Public Health Rep 1950 65(37):1175-86. Article at: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC1997098. Accessed September 22, 2017. 19. Zipkin I, Likins RC, McClure FJ, Steere AC. Urinary fluoride levels associated with the use of fluoridated water. Public Health Rep 1956 71(8):767-72. Article at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2031051. Accessed September 22, 2017. 20. Zipkin I, Likins RC. Absorption of various fluoride compounds from the gastrointestinal tract of the rat. Amer J Physicol 1957 191(3):549-50. 21. McClure FJ, Zipkin I. Physiologic effects of fluoride as related to water fluoridation. Dent Clin N Am 1958:441-58. 22. McClure FJ. Water fluoridation: the search and the victory. Bethesda, MD: National Institute of Dental Research 1970. Available at: https://www. dentalwatch.org/fl/mcclure.pdf. Accessed October 28, 2017. 23. U.S. Department of Health and Human Services, Public Health Service. Review of fluoride: benefits and risks. Report of the Ad Hoc Subcommittee on Fluoride. Washington, DC February 1991. Available at: https://health. gov/environment/ReviewofFluoride. Accessed September 22, 2017. 24. Royal College of Physicians. Fluoride, teeth and health. London Pitman Medical:1976. Abstract at: https://www.bfsweb.org/fluoride-teeth- and-health. Accessed October 28, 2017. 25. Knox EG. Fluoridation of water and cancer: a review of the epidemiological evidence. Report of the Working Party. London: Her Majesty’s Stationary Office 1985. Available at: https://archive.org/details/op1276356-1001. Accessed September 23, 2017. 26. National Research Council. Health effects of ingested fluoride. Report of the Subcommittee on Health Effects of Ingested Fluoride. Washington, DC: National Academy Press 1993. Available at: https://www.nap. edu/catalog/2204/health-effects-of-ingested-fluoride. Accessed September 23, 2017. 27. Crisp MP. Report of the Royal Commissioner into the fluoridation of public water supplies. Hobart, Tasmania, Australia: Government Printers 1968. 28. Myers DM, Plueckhahn VD, Rees ALG. Report of the committee of inquiry into fluoridation of Victorian water supplies. 1979-80 Melbourne, Victoria, Australia: FD Atkinson, Government Printer 1980:115-25. 29. Ad Hoc Committee for the U.S. Surgeon General Koop, Shapiro JR, Chairman. Report to the Environmental Protection Agency on the medical (non-dental) effects of fluoride in drinking water. 1983:1-9. 30. Duchon K. National. Fluoridation Engineer. Centers for Disease Control and Prevention. Personal communication. October 24, 2017. 31. U.S. Patent 3,091,513. Fluorine recovery. May 28, 1963. Available at: https://patents.google.com/patent/US3091513A/en. Accessed August 28, 2017. 32. U.S. Patent 3,386,892. Purification of fluosilicic acid solution by distillation with phosphoric acid solution. June 4, 1968. Available at: https://patents. google.com/patent/US3386892A/en. Accessed August 28, 2017. 33. U.S. Patent 3,615,195. Fluosilicic acid recovery. October 26, 1971. Available at: https://patents.google.com/patent/US3615195A/en. Accessed August 28, 2017. 34. U.S. Patent 3,764,658. Production of fluosilicic acid. October 9, 1973. Available at: https://patents.google.com/patent/US3764658A/en. Accessed August 28, 2017. 35. U.S. Patent 4,762,698. Method for increasing fluosilicic acid recovered from wet process phosphoric acid production. August 9, 1988. Available at: https://patents.google.com/patent/US4762698A/en. Accessed August 28, 2017. 36. U.S. Patent 4,026,990. Production of low-fluoride gypsum as a by-product in a phosphoric acid process. May 31, 1977. Available at: https://patents. google.com/patent/US4026990A/en. Accessed August 28, 2017. 37. O’Phelan, AM. Fruit’s pulp, seeds, oil all involved in making a number of products. Times Publishing Company. March 18, 2013. Available at: http:// www.tbo.com/orange-peels-and-everything-else-put-to-good- use-504764. Accessed October 2, 2017. 38. U.S. Department of Labor. Occupational Safety and Health Administration. OSHA Law & Regulation. Available at: https://www.osha.gov/law-regs. html. Accessed October 2, 2017. 39. American Water Works Association. Safety Management for Utilities. AWWA Manual M3. Seventh Edition. 2014. 40. Federal Register 2012 Mar 26 77(58):11573-896. Available at: https:// www.federalregister.gov/documents/2012/03/26/2012-4826/hazard- communication. Accessed October 2, 2017. 41. Brown R, McTigue N, Graf K. Monitoring fluoride: how closely do utilities match target versus actual levels? AWWA Opflow 2014 40(7):10-14. 42. Barker LK, Duchon KK, Lesaja S, Robison VA, Presson SM. Adjusted fluoride concentrations and control ranges in 34 states: 2006-2010 and 2015. AWWA Journal 2017 109(8):13-25. Abstract at: https://www.awwa.org/ publications/journal-awwa/abstract/articleid/65512820.aspx. Accessed October 2, 2017. Fluoridation Practice References

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