Columnists

What's in your water?

Imagine most of your friends and family living with a chronic disease that is rarely life-threatening, but it's painful and sometimes interferes with eating, sleeping and even speaking. Researchers who discovered how to reduce the rate of this disease by 25 percent would be honored as heroes, right?

This is no hypothetical scenario. During the 1940s, tooth decay was pervasive, caused many toothaches and prompted a lot of tooth extractions, but cavities were accepted as one of life's unfortunate trials. According to the U.S. Army, the number of World War II recruits disqualified because they had lost too many teeth "far exceeded all expectations." In 1945, 70 years ago this week, the city of Grand Rapids, Michigan, successfully tested a new strategy to combat tooth decay.

Months before the war ended, Grand Rapids added a small amount of fluoride--a naturally occurring mineral--to the local water system, bringing it to the optimal level to prevent tooth decay. Within years, the cavity rate among the city's children dropped dramatically.

Today, fluoridated water continues to add crucial protection against tooth decay. After reviewing 161 studies, the U.S. Community Preventive Services Task Force recommended water fluoridation in 2013, based on "strong evidence" of effectiveness. The Centers for Disease Control and Prevention evaluated fluoridation's preventive impact and declared this approach one of the 10 great public health achievements of the 20th Century.

Tooth decay is nearly always preventable, but when it occurs, it has many consequences. Studies show that children with dental problems are nearly three times more likely to miss school and are more likely to earn lower grades. Adults with unhealthy or missing teeth can be at a disadvantage when looking for jobs.

From its earliest days, fluoridation faced pockets of vocal opposition, and contemporary critics have an efficient vehicle for circulating myths and allegations: the internet. They're using new technology but decades-old arguments. Typical arguments have been examined by PolitiFact, an independent fact-checking service, and each was found to be false or deceptive.

It's appropriate to ask tough questions about any health practice, but it's inappropriate to encourage fear by circulating misleading, flawed or irrelevant research.

Water fluoridation reduces health-care costs. Research in Louisiana, New York and Texas shows that Medicaid dental expenses for children are lower in areas where water fluoridation is common. One analysis revealed that Medicaid saves more than $6 on children's dental expenses for every dollar that communities spend on water fluoridation.

Fluoridation has been a smart idea for 70 years. It continues to make sense today--for our health, our economic success and our pocketbooks.

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Patrice Pascual is executive director of the Children's Dental Health Project, a nonprofit organization in Washington, D.C.

Editorial on 01/27/2015

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