Fluoridation:Fluoridation:Nature thought of it firstNature thought of it first

By Kurt Ferre DDSBy Kurt Ferre DDS

OPHA annual meeting, Corvallis, OPHA annual meeting, Corvallis, OROR

October 11, 2011October 11, 2011

Volunteering: an opportunity

Public Health•Goal is to improve the health of a

population

• It values the “collective good”

•3 Criteria to justify public health measure:

1. reduction of ill health 2. reduction of health disparities 3. concern for children who constitute a

vulnerable group

Good Oral Health: E.P.A.

• Education

• Prevention

• Access to Care

Oral Disease “Learnings”•Cannot have good health without good

oral health

•Healthy kids learn better

•25% of the population get 80% of oral disease

•Cannot drill our way out of this “mess”

•Prevention is key

Water Fluoridation:Water Fluoridation:

DefinitionDefinition

Fluoridation is the Fluoridation is the adjustment, either adjustment, either upward or downwardupward or downward of the of the existing naturally occurring existing naturally occurring fluoride levels in drinking water to fluoride levels in drinking water to an optimal level that has been an optimal level that has been determined by our public health determined by our public health experts in the U.S.experts in the U.S.

Water Fluoridation:Water Fluoridation:

HistoryHistory

Fluoridation has been practiced in Fluoridation has been practiced in the U.S. for more than the U.S. for more than 65 years.65 years.

Grand Rapids, Michigan, fluoridated Grand Rapids, Michigan, fluoridated its public water supply on its public water supply on January January 25, 1945.25, 1945.

Water Fluoridation:Water Fluoridation:An ImportantAn Important Public Policy IssuePublic Policy Issue

Fluoridation is recognized by the Fluoridation is recognized by the U.S. Centers for Disease Control as U.S. Centers for Disease Control as one of the 10 greatest public health one of the 10 greatest public health achievements in the 20achievements in the 20thth Century. Century.

Water Fluoridation:Water Fluoridation:

HistoryHistory““Fluoridation is the Fluoridation is the

single most important single most important commitment a commitment a community can make community can make to the oral health of its to the oral health of its children and to future children and to future generations.”generations.”

- Dr. C. Everett Koop- Dr. C. Everett KoopU. S. Surgeon General, 1981-1989U. S. Surgeon General, 1981-1989

Water Fluoridation:Water Fluoridation:

HistoryHistory““Fluoridation remains an Fluoridation remains an

ideal public health ideal public health measure based on the measure based on the scientific evidence in scientific evidence in preventing dental decay preventing dental decay and its impressive cost-and its impressive cost-effectiveness.”effectiveness.”

David Satcher, MD, PhD; David Satcher, MD, PhD; Assistant Secretary for Health Assistant Secretary for Health & Surgeon General of the U.S.& Surgeon General of the U.S.

What Causes Cavities ??

•Cavities are an infectious disease

•Sugar is the food for the germs

•Germs produce acid within seconds

•A microscopic war at the tooth surface

• It is at this enamel surface that fluoride comes to the rescue

How Does Fluoride Work ??

•As the teeth grow and develop, fluoride is incorporated into the enamel.

•After the teeth erupt fluoride reverses the acid breakdown of the enamel surfaces.

•Surface enamel with fluoride is more resistant to future acid attacks.

August 17,2001/Vol. 50/No. August 17,2001/Vol. 50/No. RR.14RR.14

Fluoridation/fluoride worksFluoridation/fluoride works

• ““Because frequent exposure to small Because frequent exposure to small amounts of fluoride each day will amounts of fluoride each day will best reduce the risk for dental caries best reduce the risk for dental caries in all age groups, the work group in all age groups, the work group recommends that all persons drink recommends that all persons drink water with optimal fluoride water with optimal fluoride concentration,….”concentration,….”

• www.cdc.gov/mmwr/indrr_2001.htmlwww.cdc.gov/mmwr/indrr_2001.html

We drink through our We drink through our mouthsmouths

MMWR: September 3, 1999 / Vol. MMWR: September 3, 1999 / Vol. 48 (34); 753-75748 (34); 753-757

Louisiana Medicaid StudyLouisiana Medicaid Study

• ““Water Fluoridation and Costs of Water Fluoridation and Costs of Medicaid Treatment for Dental Decay—Medicaid Treatment for Dental Decay—Louisiana, 1995-1996Louisiana, 1995-1996

• ““Findings suggest that Medicaid-eligible Findings suggest that Medicaid-eligible children in communities without fluoridated children in communities without fluoridated water were three times more likely than water were three times more likely than Medicaid-eligible children in communities Medicaid-eligible children in communities with fluoridated water to receive dental with fluoridated water to receive dental treatment in a hospital O.R., and the cost of treatment in a hospital O.R., and the cost of dental treatment per eligible child was dental treatment per eligible child was approx. twice as high.approx. twice as high.

Head Start Dental Utilization Head Start Dental Utilization DataData

The Dalles vs. Hood River

Oregon Smile Survey Oregon Smile Survey 20072007

Fluoridation Politics

John Harris, Ctr. for Social Ethics John Harris, Ctr. for Social Ethics & Policy, Univ. of Manchester, UK& Policy, Univ. of Manchester, UK

Community Water Community Water FluoridationFluoridation““We should ask not are we entitled to We should ask not are we entitled to

impose fluoridation on unwilling people, impose fluoridation on unwilling people, but are the unwilling people entitled to but are the unwilling people entitled to impose the risks, damage & costs of the impose the risks, damage & costs of the failure to fluoridate on the community at failure to fluoridate on the community at large? When we compare the freedoms large? When we compare the freedoms at stake, the most crucial is surely the at stake, the most crucial is surely the one which involves liberation from pain one which involves liberation from pain and disease.”and disease.”

Fluoridation WebsitesFluoridation Websites

•www.cdc.gov/fluoridation

•www.ada.org/sections/newsAndEvents/

pdfs/fluoridation_facts.pdfpdfs/fluoridation_facts.pdf

•www.healthyteeth.us

•www.odha.org (click on fluoridation (click on fluoridation tab)tab)

Kurt Ferre DDS Kurt Ferre DDS kferre51@comcast.netkferre51@comcast.net