MOREHEAD CITY — While a debate continues nationally over whether fluoridation of community water systems is safe, a dentist and director of dental public health with the UNC Gillings School of Global Public Health at UNC-Chapel Hill, said it’s not only safe, but has helped prevent cavities for many years.
Rhonda Stephens, DDS, MPH, a professor and director in the Department of Public Health Leadership & Practice at UNC, and a former state dental director, assured members of the Carteret County Consolidated Human Services Board, during a meeting Aug. 11, that fluoridation of water systems at the amount recommended by the Centers for Disease (CDC) Control and Prevention has tremendous benefits, especially for young children.
“It remineralizes youth tooth enamel, reverses early tooth decay, slows down the process of demineralization and prevents the growth of cavity-causing bacteria,” she said.
She pointed out that studies, she referred to as questionable, that say fluoride can cause lower IQ in children, were mainly done in countries where there was a much higher amount of fluoride than what the CDC recommends for the United States, which is 0.7mg/L. She also questioned other processes of those studies.
Topically, fluoride is applied through water, toothpaste, mouth rinse, gel, foam and varnish. These methods increase fluoride concentration in dental plaque and saliva, resulting in continuous exposure to small amounts.
Systemically, it’s applied through fluoridated water and supplements. This method incorporates into the tooth enamel of developing primary and permanent teeth before they erupt into the mouth. It’s especially beneficial for children ages 0-8, and age 16 if they are cutting wisdom teeth.
Stephens reminded board members that fluoride is a mineral found in almost all soil, water and rocks. In surface water, it’s typically found in concentrations of 0.2 mg/L or less. In ground water (wells), it’s usually found in concentrations of 0.1 mg/L up to more than 0.5 mg/L. Ocean water typically contains 1.2 to 1.4 mg/L.
Tooth decay still remains one of the most common chronic diseases among children and adults in the U.S. Stephens said about 96% of people have experienced tooth decay by age 65.
Nearly 40% of North Carolina kindergartners have experienced tooth decay. She said 88% of NC residents on public water systems receive fluoridated water. That includes 65% in rural areas versus 97% of urban communities.
Carteret County is included in one of 10 designated state oral health regions tracked by the NC Department of Health and Human Services. Region 10, which includes Beaufort, Carteret, Craven, Jones and Lenoir counties, reports that 45.6% of kindergartners in Region 10 have experienced tooth decay, one of the highest rates in the state.
Carteret County Consolidated Human Services Director Dr. Randall Williams said the Carteret County government does not control or oversee water systems in the county and is not the regulatory agency for municipal systems. He emphasized that the county relies on state data but has no direct authority over these systems.
According to the NC Department of Environmental Quality, Carteret County has 78 water systems. These range from municipalities to schools, churches, subdivisions and more.
Of the larger water systems in the county, two municipalities, Beaufort and Morehead City, said they add fluoride to their water. Newport, West Carteret Water Corp. and Bogue Banks Water Corp., reported they do not add flouride. To find out if other county systems fluoridate, contact your individual water system or go to https://www.pwss.enr.state.nc.us.
Since fluoride occurs naturally in ground water, systems that don’t add the mineral have some naturally occurring fluoride at lower levels. According to the report, Beaufort showed the highest content of fluoride at 0.688 mg/L, well within CDC recommendations.
Despite continuing debates, Stephens said she believed the benefits of fluoride far outweigh concerns.
“Fluoride is a mineral, not a medication,” she said. “U.S. court decisions have rejected the argument that fluoride is a medication. Fluoride is a recognized nutrient for dental health. Fluoride added to water is one of several examples of everyday products fortified to improve health.”
She added that fluoridation is a public health measure, and public health measures are designed for the greater good of communities.
“Courts have recognized the right of community leaders to make fluoridation decisions,” she said. “Individuals are free to use filters or buy non-fluoridated bottled water.”
Is fluoridation still effective and necessary?
“While less of a benefit amidst other sources of fluoride, community water fluoridation (CWF) continues to show reduction in new tooth decay for both primary and permanent teeth. It’s shown to substantially reduce socioeconomic disparities in new tooth decay,” she said.
According to the CDC, fluoridated water and fluoride toothpaste work together to prevent cavities. Fluoridated water keeps a low level of fluoride in the mouth all day. Fluoride toothpaste provides a much higher concentration at important times of day such as at bedtime.
Both types of fluoride strengthen the outer tooth enamel and slow the activity of bacteria that cause cavities. Together, the two sources offer more protection than using either one alone.
Original article online at: https://www.carolinacoastonline.com/news_times/article_82550b4e-9295-4d77-a2de-edc4ff7714ab.html