The goal of water fluoridation is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies. Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide. Although it is rarely life-threatening, tooth decay can cause pain and impair eating, speaking, facial appearance, and acceptance into society, and it greatly affects the quality of life of children, particularly those of low socioeconomic status. In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there because of changing diet and inadequate fluoride exposure.
In the U.S., minorities and the poor both have higher rates of decayed and missing teeth, and their children have less dental care. Once a cavity occurs, the tooth's fate is that of repeated restorations, with estimates for the median life of an amalgam tooth filling ranging from 9 to 14 years. Oral disease is the fourth most expensive disease to treat. The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of mental retardation and goiter.
The benefits of fluoridation in preventing tooth decay have been known for over half a century and today approximately two-thirds of Americans have access to fluoridated public water.
Gerardo Maupomé, B.D.S., M.Sc., Ph.D., of the Indiana University School of Dentistry, Indiana University-Purdue University Indianapolis, and colleagues report in a study published in the Fall issue of the Journal of Public Health Dentistry that older adults benefit even more significantly from fluoridation than children.
Dr. Maupomé and his colleagues investigated whether access to fluoridated community water reduced the amounts of dental fillings and associated costs needed by children, adults, and older adults. All three groups benefited, with older adults benefiting the most.
Participants in the study were all members of a dental health maintenance organization and so had access to dental care through dental insurance. "Our finding that fluoridated water lowered the number of dental fillings confirms studies on younger people but breaks new ground on older individuals.
"Much of the focus of research on community water fluoridation has been on children. There has been significantly less research on adults and even less on older adults. Individuals are keeping their teeth through adulthood into their older years. We need to study dental health through all decades of life," said Dr. Maupomé.
