After more than 50 years of pushing community water fluoridation, the latest research from the government suggest that fluoride levels in the drinking water can be lowered due to increased amounts of fluoride in other products.
The city of Kirksville is following suit with the latest recommendations from the government and will soon be making a change to its drinking water by lowering the level of fluoride in the public water supply.
With fluoride in drinking water being a key factor in reducing cases of tooth decay, local oral heath care experts are stressing the importance of both staying at the newly-lowered levels and ensuring that fluoride remains in the drinking water supply.
Fluoride is a naturally-occurring mineral that is released from rocks into soil, air and water.
In the early 1960s, the U.S. Public Health Service made the recommendation that the optimum fluoride level in drinking water should be between 0.7 and 1.2 parts per million (ppm) of water after seeing the beneficial effects for the prevention of tooth decay.
There is a maximum level for fluoride in drinking water of 4.0 ppm and that is enforced by the U.S. Environmental Protection Agency. Too much fluoride can cause dental fluorosis of teeth, which causes white spots to appear on a tooth’s enamel surface. The condition mainly affects children whose teeth are still developing.
Earlier this year, the Public Health Service announced its new fluoride level recommendation of 0.7 ppm. In mid-September, a Kirksville resident requested that the city adjust the fluoride levels in the drinking water to be in compliance with the federal recommendation.
Kirksville Water Treatment Superintendent Blaize Brazos, who presented the idea to the City Council earlier this month, said the city had previously considered adjusting the fluoride levels and the citizen’s suggestion prompted the Public Works Department and city staff to renew the discussion.
Most areas, including Kirksville, have naturally-occurring fluoride in the water. Hazel Creek and Forest Lake each already have fluoride levels between 0.3 and 0.4 ppm.
The Missouri Department of Natural Resources does not require cities to add fluoride to their drinking water. However, Kirksville has been adding more fluoride to its drinking water to bring the level to 1.0 ppm, Brazos said.
“We add fluoride to drinking water to help with the prevention of dental cavities primarily in children and also adults,” Brazos said.
The additional fluoride does come at a price. Kirksville spends about $15,000 per year, or less than $1 per person, to add fluoride to its drinking water. Lowering the fluoride levels is estimated to cut that cost in half.
“The benefit of lowering the finished water fluoride level is primarily cost savings,” Brazos said.
The importance of fluoride in the drinking water has been a proven solution to helping prevent tooth decay, being named one of the 10 greatest public health achievements of the 20th century by the Centers for Disease Control and Prevention.
“The fluoridation in the water is very important because it helps to prevent tooth decay and makes the teeth stronger just by drinking water alone,” Dr. Tim Herbst, DDS, Dental Director at the Northeast Missouri Dental Clinic, said.
“There’s some children who may not get it from other sources, so with it in the water, they’re getting it from the water (and) they’re still getting some protective fluoride for their teeth,” Amy Carroll, health educator and outreach coordinator for the Northeast Missouri Health Council, said.
Currently, the state of Missouri is dealing with an oral health crisis due to the lack of access to oral health care. In a 2013 report, the U.S. Department of Health and Human Services stated that 101 of 114 Missouri counties were designated as dental health professional shortage areas.
But with fluoride being available in not only water, but also commercial foods, dental products and dietary supplements, higher levels of it in water are not as necessary as they were before.
“Over the years, I think they (government) realized we’re getting it in so many ways – we’re getting it from our water, we’re getting it from our food, we do get from, of course, our toothpaste and our mouthwash – so we’re getting it, so that may be why the recommendations have went down,” Carroll said.
“It’s a good thing our city is paying attention to what is going on outside of our city and looking at that and saying, ‘Oh, this is the new recommendation, this is what we should probably do,’” she said. “They’re keeping up. It’s kind of like researchers, they’re keeping up with the latest things that are happening with the government and what may be a good thing for their citizens, as well.”
As the city prepares to adjust the fluoride levels in the drinking water, Herbst said it’s important to ensure that the levels don’t get adjusted too low.
“What we don’t want to do is get rid of the fluoride completely out of our drinking water. We want to make sure we have it at optimum levels, which is by far the best,” Herbst said.
Brazos said removing all of the fluoride from the drinking water would be “prohibitively expensive” for the city, but individuals can remove all of the fluoride from their water with a reverse osmosis unit.
Since the City Council was agreeable with reducing the fluoride levels, the change will take place immediately.
“Some citizens have shown concern with fluoride levels in the drinking water. Hopefully, moving the amount from 1.0 ppm to 0.7 ppm will help address some of their concerns,” a statement from the Kirksville Public Works Department said.