90 American Dental Association • Appropriate resources monitoring capabilities should be available to ensure that the appropriate water fluoride monitoring infrastructures are in place at all times in the impacted communities.40 In a policy position released in 2012,41 the Hispanic Dental Association (HDA) noted that the HDA mission works toward the elimination of oral health disparities in the Hispanic community and that the benefits of fluoridation are critical to HDA’s endorsement. The HDA position statement41 includes the following item: Therefore, it is the position of the Hispanic Dental Association to: 1. Endorse community water fluoridation in all communities — especially the Hispanic and underserved communities — as a safe, beneficial and cost-effective public health measure based on science for preventing dental caries and to aid in the reduction of oral health disparities.41 As part of its core values42 the American Academy of Pediatrics (AAP) is dedicated to promoting optimal health and wellbeing for every child. With a strong emphasis on policy, advocacy and education,42 the AAP is a strong advocate for community water fluoridation. In support of water fluoridation43 the AAP states: Water fluoridation is a community-based intervention that optimizes the level of fluoride in drinking water, resulting in preeruptive and posteruptive protection of the teeth. Water fluoridation is a cost-effective means of preventing dental caries, with the lifetime cost per person equaling less than the cost of 1 dental restoration.43 The American Medical Association’s (AMA) mission is to promote the art and science of medicine and the betterment of public health.44 Its House of Delegates first endorsed fluoridation in 195145 and the AMA reaffirmed its support for water fluoridation in 2011.46 The American Public Health Association (APHA) champions the health of all people and all communities and speaks out for public health issues and policies backed by science.47 It has supported community water fluoridation as a safe and effective public health measure for the prevention of tooth decay since 1950.48 The APHA reaffirmed its support in 2008 by stating that it strongly endorses and recommends “the fluoridation of all community water systems as a safe and effective public health measure for the prevention of tooth decay.”49 The goal50 at the World Health Organization (WHO) is to build a better, healthier future for people all over the world. The WHO, which initially adopted policy recommending the practice of water fluoridation in 1969,51 reaffirmed its support for fluoridation in 199452 stating: Providing that a community has a piped water supply, water fluoridation is the most effective method of reaching the whole population, so that all social classes benefit without the need for active participation on the part of individuals.52 In 2004, the WHO once again affirmed its support stating that “Water fluoridation, where technically feasible and culturally acceptable, has substantial public health benefits.”53 In 2007, the Sixtieth World Health Assembly adopted WHA60.17-Oral health action plan for promotion and integrated disease prevention54 which urges member states to: (4) for those countries without access to optimal levels of fluoride, and which have not yet established systematic fluoridation programmes, to consider the development and implementation of fluoridation programmes, giving priority to equitable strategies such as the automatic administration of fluoride, for example, in drinking-water, salt or milk, and to the provision of affordable fluoride toothpaste 54 In 2016, WHO officials wrote: The use of fluoride is a major breakthrough in public health. Controlled addition of fluoride to drinking water supplies in communities where fluoride concentration is below optimal levels to have a cariostatic effect began in the 1940s and since then extensive research has confirmed the successful reduction in dental caries in many countries.55 Additionally a list of more than 35 organizations with positions/policies supporting community water fluoridation can be viewed on ADA’s website at www. ADA.org/fluoride in the section marked “Fluoridation Links.” Each organization is listed with a link to their specific fluoridation position/policy. Below are just a few of the organizations listed on the website.
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