methods of water fluoridation

[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. 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. [13], Reviews have shown that water fluoridation reduces cavities in children. [16], Public water fluoridation was first practiced in the U.S.[17] As of 2012, 25 countries have artificial water fluoridation to varying degrees, 11 of them have more than 50% of their population drinking fluoridated water. Saving Lives, Protecting People, Statement on the Evidence Supporting the Safety and Effectiveness of Community Water Fluoridation, https://www.cdc.gov/fluoridation/basics/index.htm, https://www.nidcr.nih.gov/research/data-statistics/surgeon-general, https://www.cdc.gov/fluoridation/statistics/2016stats.htm, National Center for Chronic Disease Prevention and Health Promotion, Dental Care is Safe and Important During Pregnancy, Older Adults and Tooth Loss by Smoking Status, Return on Investment: Healthcare System Savings, Cost Savings of Community Water Fluoridation, Water Fluoridation Guidelines & Recommendations, Surgeons General’s Statements on Community Water Fluoridation, Scientific Reviews and Reports: Assessing the Evidence, Estimating Community Water System Populations, Infographic: Communities Benefit from Water Fluoridation, Fluoridation Statistics — Population Methodology Changes, CDC-Sponsored Water Fluoridation Training, Implementation of School Sealant Programs, Infection Prevention & Control in Dental Settings, Summary of Infection Prevention Practices in Dental Settings, Notes To Reader, Suggested citation, and Introduction, Administrative Measures and Infection Prevention Education Training, Dental Health Care Personnel Safety and Program Evaluation, Risk Assessment, Conclusions, and Source Documents, Appendix A: Infection Prevention Checklist, Appendix A: Infection Prevention Checklist Section II: Direct Observation of Personnel and Patient-Care Practices, Appendix B: Relevant Recommendations Published by CDC since 2003, Appendix C: Selected References and Additional Resources by Topic Area, About the CDC Guidelines for Infection Control in Dental Health Care Settings—2003, Cleaning & Disinfecting Environmental Surfaces, Dental Handpieces and Other Devices Attached to Air and Waterlines, Service Animals in Dental Health Care Settings, Training: Basic Expectations for Safe Care, Selected References for Infection Prevention & Control by Topic Area, Screening and Evaluating Safer Dental Devices, Water Fluoridation Reporting System Data Stream Infographic, Implementation of Evidence-Based Preventive Interventions, School-Based and School-Linked Dental Sealant Programs, Coordinate Community Water Fluoridation Programs, Targeted Clinical Preventive Services & Health Systems Changes, Dental Caries in Permanent Teeth of Children and Adolescents, Oral Health In America: Summary of the Surgeon General’s Report, CDC Dental Public Health Residency Program, How to Apply to the CDC Dental Public Health Residency Program, Admission Requirements Checklist [PDF – 207 KB], DPHR Program Application [PDF – 237 KB], Healthy People 2020: Oral Health Objectives, U.S. Department of Health & Human Services. It is recommended by the American Dental Association, American Academy of Pediatrics, US Public Health Service, and World Health Organization. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000. [15] A systematic review found low-quality evidence to support the practice, but also concluded that further studies were needed. [2][46] Dental sealants are cost-effective only when applied to high-risk children and teeth. The full report is available elsewhere.2 Methods Search strategy [9][49] Studies in the U.S. in the 1950s and 1960s showed that water fluoridation reduced childhood cavities by fifty to sixty percent, while studies in 1989 and 1990 showed lower reductions (40% and 18% respectively), likely due to increasing use of fluoride from other sources, notably toothpaste, and also the 'halo effect' of food and drink that is made in fluoridated areas and consumed in unfluoridated ones. [29] The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of congenital hypothyroidism and goiter. [9] However this was based on older studies which failed to control for numerous variables, such as increasing sugar consumption as well as other dental strategies. You will be subject to the destination website's privacy policy when you follow the link. [55], The critical period of exposure is between ages one and four years, with the risk ending around age eight. At the commonly recommended dosage, the only clear adverse effect is dental fluorosis, which can alter the appearance of children's teeth during tooth development; this is mostly mild and is unlikely to represent any real effect on aesthetic appearance or on public health. [12][13] Other adverse effects lack sufficient evidence to reach a confident conclusion. [77], Other public-health strategies to control tooth decay, such as education to change behavior and diet, have lacked impressive results. In infants 80–90% of absorbed fluoride is retained, with the rest excreted, mostly via urine; in adults about 60% is retained. Learn also about the processes of fluoridation, desalination and distillation. [50] A 2011 European Commission systematic review based its efficacy on York's review conclusion. The U.S. Institute of Medicine has established Dietary Reference Intakes for fluoride: Adequate Intake values range from 0.01 mg/day for infants aged 6 months or less, to 4 mg/day for men aged 19 years and up; and the Tolerable Upper Intake Level is 0.10 mg/kg/day for infants and children through age 8 years, and 10 mg/day thereafter. Water fluoridation is the controlled adjustment of fluoride to a public water supply to reduce tooth decay. [31] The effectiveness of water fluoridation can vary according to circumstances such as whether preventive dental care is free to all children. [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. [28] Oral disease is the fourth most expensive disease to treat. (1955–1960). [60], In rare cases improper implementation of water fluoridation can result in overfluoridation that causes outbreaks of acute fluoride poisoning, with symptoms that include nausea, vomiting, and diarrhea. [71], Fluoride's effects depend on the total daily intake of fluoride from all sources. In 2016, more than 200 million people, or about 73% of the US population, had access to fluoridated water. [33][98] Significant reductions in tooth decay were also reported by important early studies outside the U.S., including the Brantford–Sarnia–Stratford study in Canada (1945–1962), the Tiel–Culemborg study in the Netherlands (1953–1969), the Hastings study in New Zealand (1954–1970), and the Department of Health study in the U.K.

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