The second (c. 1933–1945) focused on the relationship between fluoride concentrations, fluorosis, and tooth decay, and established that moderate levels of fluoride prevent cavities. [24] Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society,[25] and it greatly affects the quality of life of children, particularly those of low socioeconomic status. Expert Spotlight, Toxicology Excellence for Risk Assessment, http://www.nsf.org/business/water_distribution/pdf/NSF_Fact_Sheet.pdf, Register for reporter access to contact details, Newswise Live - [43], In 2011, the U.S. Department of Health and Human Services (HHS) and the U.S. Environmental Protection Agency (EPA) lowered the recommended level of fluoride to 0.7 mg/L. [104] A 2002 U.S. review estimated that on average, sealing first permanent molars saves costs when they are decaying faster than 0.47 surfaces per person-year whereas water fluoridation saves costs when total decay incidence exceeds 0.06 surfaces per person-year. In infants 80–90% of absorbed fluoride is retained, with the rest excreted, mostly via urine; in adults about 60% is retained. Hydrofluosilicic acid is a by-product of this phosphate manufacturing process. [79] Two proposed approaches, bacteria replacement therapy (probiotics) and caries vaccine, would share water fluoridation's advantage of requiring only minimal patient compliance, but have not been proven safe and effective. [80], A 2007 Australian review concluded that water fluoridation is the most effective and socially the most equitable way to expose entire communities to fluoride's cavity-prevention effects. Dental fluorosis can occur when children regularly consume higher-than-recommended amounts of fluoride during the teeth-forming years (age 8 and younger). [72] A rough estimate is that an adult in a temperate climate consumes 0.6 mg/day of fluoride without fluoridation, and 2 mg/day with fluoridation. [12] There is no clear evidence of other adverse effects from water fluoridation. Although no major differences between natural and artificial fluoridation were apparent, the evidence was inadequate for a conclusion about any differences. [16] Other fluoride therapies are also effective in preventing tooth decay;[24] they include fluoride toothpaste, mouthwash, gel, and varnish,[73] and fluoridation of salt and milk. After the sugar is gone, some of the mineral loss can be recovered—or remineralized—from ions dissolved in the saliva. In 2004, an estimated 13.7 million people in western Europe and 194 million in the U.S. received artificially fluoridated water. Some countries and communities have discontinued fluoridation, while others have expanded it. [83] On 26 August 2014, Israel stopped mandating fluoridation, stating "Only some 1% of the water is used for drinking, while 99% of the water is intended for other uses (industry, agriculture, flushing toilets etc.). [2] Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide. [3] A 2004 World Health Organization review stated that water fluoridation, when it is culturally acceptable and technically feasible, has substantial advantages in preventing tooth decay, especially for subgroups at high risk. This standard establishes criteria for the evaluation of treatment chemicals to ensure that they, and any potential contaminants, do not cause adverse health effects when they are dosed into drinking water at the manufacturer’s stated maximum use level. [57] Other sources include dental products other than toothpaste; air pollution from fluoride-containing coal or from phosphate fertilizers; trona, used to tenderize meat in Tanzania; and tea leaves, particularly the tea bricks favored in parts of China. [94], McKay's work had established that fluorosis occurred before tooth eruption. [9] A 2020 study in the Journal of Political Economy found that water fluoridation significantly improved dental health and labor market outcomes, but had non-significant effects on cognitive ability. Centers for Disease Control and Prevention", Guidelines for Drinking-water Quality, 4th Edition, "Bottled, filtered, and tap water use in Latino and non-Latino children", "Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach", "Water fluoridation for the prevention of dental caries", "Introduction to the SCHER opinion on Fluoridation", "A systematic review of the efficacy and safety of fluoridation", "A systematic review of public water fluoridation", "Fluoridation of drinking water: a systematic review of its efficacy and safety", "Systematic review of water fluoridation", "The York review--a systematic review of public water fluoridation: a commentary", "The effective use of fluorides in public health", "What role does fluoride play in preventing tooth decay? [19] Major health organizations such as the World Health Organization and FDI World Dental Federation supported water fluoridation as safe and effective. [34], In the first half of the 19th century, investigators established that fluoride occurs with varying concentrations in teeth, bone, and drinking water. Fluoride is a mineral that occurs naturally and is released from rocks into the soil, water, and air. In very unusual instances, pits may form in the teeth. For example, Jamaica has just one salt producer, but a complex public water supply; it started fluoridating all salt in 1987, achieving a decline in cavities. An estimated 51 million school hours and 164 million work hours are lost each year due to dental-related illness. [63] Although it has been hypothesized that hydrofluosilicic acid and sodium silicofluoride might increase human lead uptake from water, a 2006 statistical analysis did not support concerns that these chemicals cause higher blood lead concentrations in children. universities, institutions, and journalists to spread breaking news to their [92], The foundation of water fluoridation in the U.S. was the research of the dentist Frederick McKay (1874–1959). Phosphate containing rocks and minerals are reacted with sulfuric acid to produce phosphate which is used in a wide variety of products from soft drinks and other foods, to cleaning products and, yes, even fertilizer.

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