when did water fluoridation begin in the uk
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authorities to fluoridate their water. The following UK water utility companies fluoridate their supply: Earlier plans were undertaken in the Health Authority areas of Bedfordshire, Hertfordshire, Birmingham, Black Country, Cheshire, Merseyside, County Durham, Tees Valley, Cumbria, Lancashire, North, East Yorkshire, Northern Lincolnshire, Northumberland, Tyne and Wear, Shropshire, Staffordshire, Trent and West Midlands South whereby fluoridation was introduced progressively in the years between 1964 and 1988. The South Central Strategic Health Authority carried out the first public consultation under the Water Act 2003, and in 2009 its board voted to fluoridate water supplies in the Southampton area to address the high
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authorities to fluoridate their water. The following UK water utility companies fluoridate their supply: Earlier plans were undertaken in the Health Authority areas of Bedfordshire, Hertfordshire, Birmingham, Black Country, Cheshire, Merseyside, County Durham, Tees Valley, Cumbria, Lancashire, North, East Yorkshire, Northern Lincolnshire, Northumberland, Tyne and Wear, Shropshire, Staffordshire, Trent and West Midlands South whereby fluoridation was introduced progressively in the years between 1964 and 1988. The South Central Strategic Health Authority carried out the first public consultation under the Water Act 2003, and in 2009 its board voted to fluoridate water supplies in the Southampton area to address the high
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used by 65% of the population served by a piped water supply. Fluoridation was introduced into Brazil in 1953, was regulated by federal law starting in 1974, and by 2004 was used by 71% of the population. In the Republic of Ireland, fluoridation was legislated in 1960, and after a constitutional challenge the two major cities of Dublin and Cork began it in 1964; fluoridation became required for all sizeable public water systems and by 1996 reached 66% of the population. In other locations, fluoridation was used and then discontinued: in Kuopio, Finland, fluoridation was used for decades but was
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Council decided to not add fluoride to its water supply. Fluoride has been added to water supplies in Canberra and the City of Queanbeyan since 1964. The addition of fluoride is regulated by the Electricity and Water (Amendment) Act (No. 2) 1989 and the Public Health (Drinking Water) Code of Practice 2007 (No 1). There was a brief period in 1989 where fluoridation was suspended following a formal review of the effectiveness of fluoridation on oral health. As only one water supplier provides all of the water for these areas, the percentage of the population with access to fluoridated water
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council decided to discontinue water fluoridation. The previous government, under Queensland Premier Anna Bligh, announced on 5 December 2007 that the mandatory fluoridation of most of Queensland's water supplies will begin in 2008. When it was enacted the Water Fluoridation Act 2008 required the addition of fluoride to any water supply supplying potable water to at least 1000 members of the public, unless an exemption is granted based on safety or naturally occurring levels that meet the required levels. The fluoridation of drinking water supplies is regulated by Queensland Health, with implementation supported by the former Department of Employment, Economic
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city in the United States that did not add fluoride to its public water supply, and fluoridation has historically been a subject of controversy in the city. Portland voters have four times voted against fluoridation, in 1956, 1962, 1980 (repealing a 1978 vote in favor), and 2013. In 2012 the city council, responding to advocacy from public health organizations and others, voted unanimously to begin fluoridation by 2014. Fluoridation opponents forced a public vote on the issue, and on May 21, 2013, city voters again rejected fluoridation. Strong free speech protections of the Oregon Constitution upheld by the Oregon Supreme
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reinstating fluoridation in public drinking water after a 2004 ballot initiative ceased water fluoridation in the city. At the same time, voters in Xenia, Ohio; Springfield, Ohio; Bellingham, Washington; and Tooele City, Utah all rejected water fluoridation. In Skagit County in the state of Washington, the county commissioners in 2007 voted 2 to 1 to order the local public utility district to begin fluoridating the public water supply by Jan. 2009. $1.2 million was to be provided by the privately funded Washington Dental Service Foundation to begin building the equipment needed to add fluoride to the Judy Reservoir, which supplies
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in Portland, the first being in 1956. On September 12, 2012, the Portland City Council unanimously passed Ordinance No. 185612, authorizing and directing the Portland Water Bureau to begin fluoridating. Those opposing the ordinance immediately began a petition process to hold a referendum that could reverse the ordinance. In October, it was revealed that four city council members had had undisclosed meetings with pro-fluoridation lobbyists. Public calendars of those four did not mention the meetings, except that one meeting was mentioned with a vague title. This was in violation of a city ordinance requiring the disclosure of such meetings. Over
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the national dental associations of Australia, Canada, and the U.S. The American Dental Association calls water fluoridation "one of the safest and most beneficial, cost-effective public health measures for preventing, controlling, and in some cases reversing, tooth decay." In the English speaking nations—the United States, Canada, UK, Australia and New Zealand, all of which practice water fluoridation—many medical associations and authorities have published position statements and endorsed water fluoridation. The U.S. Surgeon General, the American Public Health Association, the Royal Commission on the National Health Service, Australian Medical Association, New Zealand Medical Association, Health Canada supports fluoridation, citing a number
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Asian country to institute a water fluoridation program that covered 100% of the population. Water is fluoridated to a typical value of 0.4-0.6 mg per litre. Only about 4% of the population of Vietnam has water fluoridation, whereas only 70% get their water from public supplies. Out of a population of about three-quarters of a billion, under 14 million people (approximately 2%) in Europe receive artificially-fluoridated water. Those people are in the UK (5,797,000), Republic of Ireland (3,250,000), Spain (4,250,000), and Serbia (300,000). The first water fluoridation in Europe was in West Germany and Sweden in 1952, bringing fluoridated water
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UK performed in 1999 found that while a 62% majority favored water fluoridation in the city, the 31% who were opposed expressed their preference with greater intensity than supporters. Every year in the U.S., pro- and anti-fluoridationists face off in referenda or other public decision-making processes: in most of them, fluoridation is rejected. Despite support by public health organizations and authorities, the practice is controversial as a public health measure; some countries and communities have discontinued it, while others have expanded it. In the U.S., rejection in state and local communities is more likely when the decision is made by
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since 1973. In "Ryan v. Attorney General" (1965), the Supreme Court of Ireland held that water fluoridation did not infringe the plaintiff's right to bodily integrity. The court found that such a right to bodily integrity did exist, despite the fact that it was not explicitly mentioned in the Constitution of Ireland, thus establishing the doctrine of unenumerated rights in Irish constitutional law. Fluoridation has been the subject of many court cases wherein activists have sued municipalities, asserting that their rights to consent to medical treatment and due process are infringed by mandatory water fluoridation. Individuals have sued municipalities for
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it back. In March 2013, after a 6–1 vote, the county resumed the addition of fluoride, which the "Times" characterized as being "long considered the most effective method to prevent tooth decay". Nickens and Ruth were awarded the 2013 Pulitzer Prize for Editorial Writing for their series. The Board of County Commissioners of Hernando County, Florida voted, 4–1, on February 25, 2014 not to begin fluoridating the county's water. On May 21, 2013, voters in Portland, Oregon decided 61–39% not to commence fluoridation of Portland's water, which is supplied to 900,000 people. It was the fourth defeat of fluoridation proposals
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A fluoride cessation study found that consistent with a previously observed population-wide phenomenon that the rate of cavities continued to drop after the fluoride concentration in water fell from the augmented 1.0 ppm to its natural level below 0.2 ppm. Water fluoridation was discontinued after the German reunification. There is no water fluoridation in Greece. In the early 1960s the city of Szolnok briefly fluoridated its water. The program was discontinued due to technical problems and a public view that fluoridation did not seem reasonable. Hungary has not used artificially fluoridated water since then. Near the end of 2015, Ireland
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dental associations throughout the world have endorsed water fluoridation as safe and effective. The views on the most effective method for community prevention of tooth decay are mixed. The Australian government states that water fluoridation is the most effective means of achieving fluoride exposure that is community-wide. The World Health Organization states water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk, while the European Commission finds no advantage to water fluoridation compared with topical use. FDI World Dental Federation supports water fluoridation as safe and effective. the European Academy of Paediatric Dentistry, and
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others not. 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. A 2000 UK systematic review (York) found that water fluoridation was associated with a decreased proportion of children with cavities of 15% and with a decrease in decayed, missing, and filled primary
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As fluoridation does not appear to be an important issue for the general public in the U.S., the debate may reflect an argument between two relatively small lobbies for and against fluoridation. A survey of Australians in 2009 found that 70% supported and 15% opposed fluoridation. Those opposed were much more likely to score higher on outrage factors such as "unclear benefits". A study of focus groups from 16 European countries in 2003 found that fluoridation was opposed by a majority of focus group members in most of the countries, including France, Germany, and the UK. A survey in Sheffield,
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to be of aesthetic or public health concern. There is no clear evidence of other adverse effects from water fluoridation. Fluoride's effects depend on the total daily intake of fluoride from all sources. Drinking water is typically the largest source; other methods of fluoride therapy include fluoridation of toothpaste, salt, and milk. The views on the most efficient method for community prevention of tooth decay are mixed. The Australian government states that water fluoridation is the most effective way to achieve fluoride exposure that is community-wide. The World Health Organization reports that water fluoridation, when feasible and culturally acceptable, has
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decay incidence exceeds 0.06 surfaces per person-year. In the U.S., water fluoridation is more cost-effective than other methods to reduce tooth decay in children, and a 2008 review concluded that water fluoridation is the best tool for combating cavities in many countries, particularly among socially disadvantaged groups. A 2016 review of studies published between 1995 to 2013 found that water fluoridation in the U.S. was cost-effective, and that it was more so in larger communities. U.S. data from 1974 to 1992 indicate that when water fluoridation is introduced into a community, there are significant decreases in the number of employees
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neighbouring parts of south-west Hampshire due to opposition from both Hampshire County Council and Southampton City Council. It was reported in 2007 that the UK Milk Fluoridation Programme, centered in the northwest of England, involved more than 16,000 children. The water supply in Northern Ireland has never been artificially fluoridated except in two small localities where fluoride was added to the water for about 30 years. By 1999, fluoridation ceased in those two areas, as well. In 2004, following a public consultation, Scotland's parliament rejected proposals to fluoridate public drinking water. The decision whether to fluoridate lies with local governments,
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Before the 2008 legislation the addition of fluoride to water supplies was regulated by the Fluoridation of Water Supplies Act 1963. Under this legislation only 5% of drinking water supplies were fluoridated. Queensland was unique in that it did not pursue water fluoridation like all the other Australian States and Territories, with only 7 of the 850 fluoridated supplies in 1984 operating in Queensland. Those supplies operated in the towns of Biloela, Dalby, Gatton, Mareeba, Moranbah, and Townsville/Thuringowa, with some adding fluoride to their drinking water since 1972. A few of these towns stopped adding fluoride prior to the Water
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public-health concern. There is no clear evidence of other adverse effects from water fluoridation, as revealed by the York review from 2000. A 2007 Australian systematic review used the same inclusion criteria as York's, plus one additional study. This did not affect the York conclusions. Fluoride's effects depend on the total daily intake of fluoride from all sources. Drinking water is typically the largest source; other methods of fluoride therapy include fluoridation of toothpaste, salt, and milk. The views on the most effective method for community prevention of tooth decay are mixed. The Australian government states that water fluoridation is
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group and opposed by the Fine Gael-Labour government and Fianna Fáil. Recently there is much local opposition to the national fluoridation mandate. Early in 2014, Cork County Council and Laois County Council passed motions for the cessation of water fluoridation. In Autumn 2014, Cork City Council, Dublin City Council, and Kerry County Council passed similar motions. There is no water fluoridation in Latvia. Riga's upper limit on natural fluoride is 1.5 mg/l. Water was fluoridated in large parts of the Netherlands from 1960 to 1973, when the High Council of The Netherlands declared fluoridation of drinking water unauthorized. Dutch authorities
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a public referendum; in Europe, most decisions against fluoridation have been made administratively. Neither side of the dispute appears to be weakening or willing to concede. Water fluoridation is used in the United States, United Kingdom, Ireland, Canada, Australia, Israel and a handful of other countries. The following nations previously fluoridated their water, but stopped the practice, with the years when water fluoridation started and stopped in parentheses: In the United Kingdom a strategic health authority can direct a water company to fluoridate the water supply in an area if it is technically possible. The strategic health authority must consult
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effect' of food and drink that is made in fluoridated areas and consumed in unfluoridated ones. A 2000 UK systematic review (York) found that water fluoridation was associated with a decreased proportion of children with cavities of 15% and with a decrease in decayed, missing, and filled primary teeth (average decreases was 2.25 teeth). The review found that the evidence was of moderate quality: few studies attempted to reduce observer bias, control for confounding factors, report variance measures, or use appropriate analysis. Although no major differences between natural and artificial fluoridation were apparent, the evidence was inadequate for a conclusion
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with conspirators that included industrialist Andrew Mellon and the Mellon Institute's researcher Gerald J. Cox, the Kettering Laboratory of the University of Cincinnati, the Federal Security Agency's administrator Oscar R. Ewing, and public-relations strategist Edward Bernays. Specific antifluoridation arguments change to match the spirit of the time. Outside North America, water fluoridation was adopted in some European countries, but in the late 1970s and early 1980s, Denmark and Sweden banned fluoridation when government panels found insufficient evidence of safety, and the Netherlands banned water fluoridation when "a group of medical practitioners presented evidence" that it caused negative effects in a
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just one salt producer, but a complex public water supply; it started fluoridating all salt in 1987, achieving a decline in cavities. Universal salt fluoridation is also practiced in Colombia and the Swiss Canton of Vaud; in Germany fluoridated salt is widely used in households but unfluoridated salt is also available, giving consumers a choice. Concentrations of fluoride in salt range from 90 to 350 mg/kg, with studies suggesting an optimal concentration of around 250 mg/kg. Milk fluoridation is practiced by the Borrow Foundation in some parts of Bulgaria, Chile, Peru, Russia, Macedonia, Thailand and the UK. Depending on location,
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about any differences. A 2007 Australian systematic review used the same inclusion criteria as York's, plus one additional study. This did not affect the York conclusions. A 2011 European Commission systematic review based its efficacy on York's review conclusion. A 2015 Cochrane systematic review estimated a reduction in cavities when water fluoridation was used by children who had no access to other sources of fluoride to be 35% in baby teeth and 26% in permanent teeth. The evidence was of poor quality. Fluoride may also prevent cavities in adults of all ages. A 2007 meta-analysis by CDC researchers found that
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in response, which can be considerable even when the dosage is fixed. Proponents and opponents have been both criticized for overstating the benefits or overstating the risks, and understating the other, respectively. Systematic reviews have cited the lack of high-quality research for the benefits and risks of water fluoridation and questions that are still unsettled. A 2007 Nuffield Council on Bioethics report concluded that good evidence for or against water fluoridation is lacking. Researchers who oppose the practice state this as well. According to a 2013 Congressional Research Service report on fluoride in drinking water, these gaps in the fluoridation
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a number of illnesses that they believe were caused by fluoridation of the city's water supply. In most of these cases, the courts have held in favor of cities, finding no or only a tenuous connection between health problems and widespread water fluoridation. To date, no federal appellate court or state court of last resort (i.e., state supreme court) has found water fluoridation to be unlawful. Water fluoridation controversy The water fluoridation controversy arises from political, moral, ethical, economic, and health considerations regarding the fluoridation of public water supplies. Public health authorities throughout the world find a medical consensus that
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and Huia Village don't fluoridate water. In 2013, a Hamilton City Council committee voted to remove fluoride from late June 2013. A referendum was held during the council elections in October 2013 with approximately 70% of voters voting for fluoride to be added back into the water supply, and in March 2014, the council voted 9 to 1 to re-introduce fluoride into the supply. In a 2007 referendum about half of voters in the Central Otago, South Otago and the Southland Region did not want fluoridation and voters in the Waitaki District were against water fluoridation for all Wards. Ashburton
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Water fluoridation controversy The water fluoridation controversy arises from political, moral, ethical, economic, and health considerations regarding the fluoridation of public water supplies. Public health authorities throughout the world find a medical consensus that fluoride therapy at appropriate levels is a safe and effective means to prevent dental caries, whether by fluoridation of the public water supply or topical application strategies. Proponents of water fluoridation see it as a question of public health policy and equate the issue to vaccination and food fortification, claiming significant benefits to dental health and minimal risks. In contrast, opponents of water fluoridation view it
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U.S., including Argentina, Australia, Brazil, Canada, Chile, Colombia, Hong Kong, Ireland, Israel, Korea, Malaysia, New Zealand, the Philippines, Serbia, Singapore, Spain, the UK, and Vietnam. In 2004, an estimated 13.7 million people in western Europe and 194 million in the U.S. received artificially fluoridated water. In 2010, about 66% of the U.S. population was receiving fluoridated water. Naturally fluoridated water is used by approximately 4% of the world's population, in countries including Argentina, France, Gabon, Libya, Mexico, Senegal, Sri Lanka, Tanzania, the U.S., and Zimbabwe. In some locations, notably parts of Africa, China, and India, natural fluoridation exceeds recommended levels.
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of California declined to hear the case in February 2006. Since 2000, courts in Washington, Maryland, and Texas have reached similar conclusions. San Diego, California began water fluoridation in February 2011, despite its Municipal Code Section 67.0101, which prohibits the city from fluoridating. The local ordinance was preempted by California law that requires fluoridation when an outside funding source is available. In 2008, First 5 Commission of San Diego County, a state-funded child advocacy organization, provided nearly $4 million to San Diego, for fluoridation equipment and operating costs for the first two years of fluoridation. That organization is funded with
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$ per person-year. Defluoridation is needed when the naturally occurring fluoride level exceeds recommended limits. In 2011 the World Health Organization suggested a level of fluoride from 0.5 to 1.5 mg/L (milligrams per litre), depending on climate, local environment, and other sources of fluoride. Bottled water typically has unknown fluoride levels. Tooth decay remains a major public health concern in most industrialized countries, affecting 60–90% of schoolchildren and the vast majority of adults. Water fluoridation reduces cavities in children, while efficacy in adults is less clear. A Cochrane review estimates a reduction in cavities when water fluoridation was used by
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Communities have discontinued water fluoridation in some countries, including Finland, Germany, Japan, the Netherlands, and Switzerland. 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.). There is also scientific evidence that fluoride in large amounts can lead to damage to health. When fluoride is supplied via drinking water, there is no control regarding the amount of fluoride actually consumed, which could lead to excessive consumption. Supply of fluoridated water forces those who do not so
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industrial countries to treat dental fluorosis, which is mostly due to fluoride from swallowed toothpaste. Although a 1989 workshop on cost-effectiveness of cavity prevention concluded that water fluoridation is one of the few public health measures that save more money than they cost, little high-quality research has been done on the cost-effectiveness and solid data are scarce. Dental sealants are cost-effective only when applied to high-risk children and teeth. 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
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33,000 signatures were gathered for the petition, which led to the referendum that defeated fluoridation. In the campaign, the pro-fluoridation side out-raised opponents $850,000 to $270,000. Water fluoridation in the United States As with some other countries, water fluoridation in the United States is a contentious issue. As of May 2000, 42 of the 50 largest U.S. cities had water fluoridation. On January 25, 1945, Grand Rapids, Michigan, became the first community in the United States to fluoridate its drinking water to prevent tooth decay. Fluoridation became an official policy of the U.S. Public Health Service by 1951, and by
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Water fluoridation in Australia Australia is one of many countries that have water fluoridation programs currently operating (see Fluoridation by country). As of March 2012, artificially fluoridated drinking water is provided for 70% or more of the population in all states and territories. The acceptance of the benefits of water fluoridation occurred in Australia in December 1953, roughly two years after acceptance in the United States. Many of Australia's drinking water supplies subsequently began fluoridation in the 1960s and 1970s. By 1984 almost 66% of the Australian population had access to fluoridated drinking water, represented by 850 towns and cities.
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Water fluoridation in the United States As with some other countries, water fluoridation in the United States is a contentious issue. As of May 2000, 42 of the 50 largest U.S. cities had water fluoridation. On January 25, 1945, Grand Rapids, Michigan, became the first community in the United States to fluoridate its drinking water to prevent tooth decay. Fluoridation became an official policy of the U.S. Public Health Service by 1951, and by 1960 water fluoridation had become widely used in the U.S., reaching about 50 million people. By 2006, 69.2% of the U.S. population on public water systems
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to oral health and nutrition education programs. Windsor's water had been fluoridated for over fifty years. Lakeshore and Amherstberg have voted to end water fluoridation. Hamilton, London, and Toronto have recently chosen to continue fluoridation. Toronto treats its water to 0.6 mg/L. Mexico has no water fluoridation program; instead it has a table salt fluoridation program. As of May 2000, 42 of the 50 largest U.S. cities had water fluoridation. In 2010, 66% of all U.S. residents and 74% of U.S. residents with access to community water systems receive fluoridated water. In 2010, a U.S. Centers for Disease Control and
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that water fluoridation prevented an estimated 27% of cavities in adults, about the same fraction as prevented by exposure to any delivery method of fluoride (29% average). A 2011 European Commission review found that the benefits of water fluoridation for adult in terms of reductions in decay are limited. 2015 Cochrane review found no conclusive research in adults. Most countries in Europe have experienced substantial declines in cavities without the use of water fluoridation. For example, in Finland and Germany, tooth decay rates remained stable or continued to decline after water fluoridation stopped. Fluoridation may be useful in the U.S.
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with the local community and businesses in the affected area. The water company will act as a contractor in any new schemes and cannot refuse to fluoridate the supply. In areas with complex water sources, water fluoridation is more difficult and more costly. Alternative fluoridation methods have been proposed, and implemented in some parts of the world. The World Health Organization (WHO) is currently assessing the effects of fluoridated toothpaste, milk fluoridation and salt fluoridation in Africa, Asia, and Europe. The WHO supports fluoridation of water in some areas. In some other countries, sodium fluoride is added to table salt.
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fluoridation. Fluoridation became an official policy of the U.S. Public Health Service by 1951, and by 1960 water fluoridation had become widely used in the U.S., reaching about 50 million people. By 2006, 69.2% of the U.S. population on public water systems were receiving fluoridated water, amounting to 61.5% of the total U.S. population; 3.0% of the population on public water systems were receiving naturally occurring fluoride. In some other countries the pattern was similar. New Zealand, which led the world in per-capita sugar consumption and had the world's worst teeth, began fluoridation in 1953, and by 1968 fluoridation was
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cavities when water fluoridation was used by children who had no access to other sources of fluoride to be 35% in baby teeth and 26% in permanent teeth. Most European countries have experienced substantial declines in tooth decay without its use. Recent studies suggest that water fluoridation, particularly in industrialized countries, may be unnecessary because topical fluorides (such as in toothpaste) are widely used and caries rates have become low. Although fluoridation can cause dental fluorosis, which can alter the appearance of developing teeth or enamel fluorosis, the differences are mild and usually not considered to be of aesthetic or
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to have fluoridation, and its availability was greatly expanded in the 1980s, with optimum fluoridation levels set at 0.8 mg/L. Today, the expansion of fluoridation in Brazil is a governmental priority; Between 2005 and 2008, fluoridation became available to 7.6 million people in 503 municipalities. As of 2008, 3,351 municipalities (60.6%) had adopted fluoridation, up from 2,466 in 2000. In Chile 70.5% of the population receives fluoridated water (10.1 million added by chemical means, 604,000 naturally occurring). The Biobio Region is the only administrative division that doesn't fluoridate water. Fluoridation by country Water fluoridation is the controlled addition of fluoride
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to about 42,000 people. By mid-1962, about 1 million Europeans in 18 communities in 11 countries were receiving fluoridated water. Many European countries have rejected water fluoridation, including: Austria, Belgium, Finland, France, Germany, Hungary, Luxembourg, Netherlands, Northern Ireland, Norway, Sweden, Switzerland, Scotland, Iceland, and Italy. A 2003 survey of over 500 Europeans from 16 countries concluded that "the vast majority of people opposed water fluoridation". Austria has never implemented fluoridation. Belgium does not fluoridate its water supply, although legislation permits it. Czech Republic (previously Czechoslovakia) started water fluoridation in 1958 in Tábor. In Prague fluoridation started in 1975. It was
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water naturally fluoridated to high levels; the report recommended lowering the U.S. maximum limit of 4 mg/L for fluoride in drinking water. Water was fluoridated in large parts of the Netherlands from 1960 to 1973, at which point the Supreme Court of the Netherlands declared fluoridation of drinking water unauthorized. The Dutch Court decided that authorities had no legal basis for adding chemicals to drinking water if they did not also improve safety. It was also stated as support that consumers cannot choose a different tap water provider. Drinking water has not been fluoridated in any part of the Netherlands
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Under the Act, the need to add fluoride to a water supply is assessed by a fluoridation committee, which then provides a recommendation to the Health Minister. The Health Minister may then choose to direct the water authority to add fluoride to the water. Approximately 95% of the population has access to fluoridated water (September 2011). Fluoridation commenced in New South Wales with Yass in 1956, with Sydney fluoridating in 1968. The use of fluoride is regulated by the Fluoridation of Public Water Supplies Act 1957, and the Fluoridation of Public Water Supplies Regulation 2007. In November 2013, Byron Shire
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where the fluoride content is too high. Legislation around mandatory fluoridation was introduced in 2002, but has been delayed since then pending further research after opposition from water companies, municipalities and the public. Approximately 947,000 (7% of the population) receives water with naturally occurring fluoride in it. Roughly 2,600,000 (21% of the population) receives water with naturally occurring fluoride in it. Fluoridation is banned in China. Naturally high fluoride levels in water are a serious problem in China. As of 2003, there is no water fluoridation in China. Water fluoridation began in 1965 in the urban area of Guangzhou. It
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fluoridation. According to a 2002 study, 67% of U.S. residents were living in communities with fluoridated water at that time. The U.S. Centers for Disease Control has identified community water fluoridation as one of ten great public health achievements of the 20th century. The CDC recommends water fluoridation at a level of 0.7–1.2 mg/L, depending on climate. The CDC also advises parents to monitor use of fluoride toothpaste, and use of water with fluoride concentrations above 2 mg/L, in children up to age 8. There is a CDC database for researching the water fluoridation status of neighborhood water. In 1998,
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the most effective means of achieving fluoride exposure that is community-wide. The World Health Organization states water fluoridation, when feasible and culturally acceptable, has substantial advantages, especially for subgroups at high risk, while the European Commission finds no advantage to water fluoridation compared with topical use. Currently about 372 million people (around 5.7% of the world population) receive artificially-fluoridated water in about 24 countries, including Australia, Brazil, Canada, Chile, Ireland, Malaysia, the U.S., and Vietnam. With 57.4 million people who receive naturally occurring fluoridated water at or above optimal levels in countries such as Sweden, China, Sri Lanka, Finland, Zimbabwe
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uptake from water, a 2006 statistical analysis did not support concerns that these chemicals cause higher blood lead concentrations in children. Trace levels of arsenic and lead may be present in fluoride compounds added to water, but no credible evidence exists that their presence is of concern: concentrations are below measurement limits. The effect of water fluoridation on the natural environment has been investigated, and no adverse effects have been established. Issues studied have included fluoride concentrations in groundwater and downstream rivers; lawns, gardens, and plants; consumption of plants grown in fluoridated water; air emissions; and equipment noise. Fluoride exerts
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per dental firm and the number of dental firms. The data suggest that some dentists respond to the demand shock by moving to non-fluoridated areas and by retraining as specialists. The water fluoridation controversy arises from political, moral, ethical, economic, and safety concerns regarding the water fluoridation of public water supplies. Public health authorities throughout the world state that water fluoridation at appropriate levels is a safe and effective means to prevent dental caries. Authorities' views on the most effective fluoride therapy for community prevention of tooth decay are mixed; some state water fluoridation is most effective, while others see
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demineralization exceeds the rate of remineralization, typically in a process that requires many months or years. All fluoridation methods, including water fluoridation, create low levels of fluoride ions in saliva and plaque fluid, thus exerting a topical or surface effect. A person living in an area with fluoridated water may experience rises of fluoride concentration in saliva to about 0.04 mg/L several times during a day. Technically, this fluoride does not prevent cavities but rather controls the rate at which they develop. When fluoride ions are present in plaque fluid along with dissolved hydroxyapatite, and the pH is higher than
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American public health. In recent years water fluoridation has become a prevalent health and political issue in many countries, resulting in some countries and communities discontinuing its use while others have expanded it. The controversy is propelled by a significant public opposition supported by a minority of professionals, which include researchers, dental and medical professionals, alternative medical practitioners, health food enthusiasts, a few religious groups (mostly Christian Scientists in the U.S.), and occasionally consumer groups and environmentalists. Organized political opposition has come from libertarians, the John Birch Society, and from groups like the Green parties in the UK and New
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water fluoridation prevented an estimated 27% of cavities in adults, about the same fraction as prevented by exposure to any delivery method of fluoride (29% average). A 2011 European Commission review found that the benefits of water fluoridation for adult in terms of reductions in decay are limited. A 2015 Cochrane review found no conclusive research regarding the effectiveness of water fluoridation in adults. A 2016 review found variable quality evidence that, overall, stopping of community water fluoridation programs was typically followed by an increase in cavities. Most countries in Europe have experienced substantial declines in cavities without the use
Water fluoridation
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Zealand. Proponents and opponents have been both criticized for overstating the benefits or overstating the risks, and understating the other, respectively. Systematic reviews have cited the lack of high quality research for the benefits and risks of water fluoridation and questions that are still unsettled. Researchers who oppose the practice state this as well. According to a 2013 Congressional Research Service report on fluoride in drinking water, these gaps in the fluoridation scientific literature fuel the controversy. Public water fluoridation was first practiced in 1945, in the US. As of 2012, 25 countries have supplemental water fluoridation to varying degrees,
Water fluoridation controversy
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and Greymouth also voted against fluoridation. In 2014, the Prime Minister's Chief Science Advisor and the Royal Society of New Zealand published a report on the health effects of water fluoridation. In June 2018, the Supreme Court of New Zealand in "New Health New Zealand Inc v South Taranaki District Council" upheld the legality of water fluoridation in New Zealand. By 2008, 41% of people (73.2 million) in Brazil were getting artificially-fluoridated water. Water fluoridation was first adopted in Brazil in the city of Baixo Guandu, ES, in 1953. A 1974 federal law required new or enlarged water treatment plants
Fluoridation by country
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rights to consent to medical treatment and due process are infringed by mandatory water fluoridation. Individuals have sued municipalities for a number of illnesses that they believe were caused by fluoridation of the city's water supply. In most of these cases, the courts have held in favor of cities, finding no or only a tenuous connection between health problems and widespread water fluoridation. To date, no federal appellate court or state court of last resort (i.e., state supreme court) has found water fluoridation to be unlawful. A flurry of cases were heard in numerous state courts across the U.S. in
Water fluoridation in the United States
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the 1950s during the early years of water fluoridation. State courts consistently held in favor of allowing fluoridation to continue, analogizing fluoridation to mandatory vaccination and the use of other chemicals to clean the public water supply, both of which had a long-standing history of acceptance by courts. In 1952, a Federal Regulation was adopted that stated in part, "The Federal Security Agency will regard water supplies containing fluorine, within the limitations recommended by the Public Health Service, as not actionable under the Federal Food, Drug, and Cosmetic Act." The Supreme Court of Oklahoma analogized water fluoridation to mandatory vaccination
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is the most effective and socially the most equitable way to expose entire communities to fluoride's cavity-prevention effects. A 2002 U.S. review estimated that sealants decreased cavities by about 60% overall, compared to about 18–50% for fluoride. A 2007 Italian review suggested that water fluoridation may not be needed, particularly in the industrialized countries where cavities have become rare, and concluded that toothpaste and other topical fluoride are the best way to prevent cavities worldwide. 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,
Water fluoridation
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fluoridation in the U.S. was the research of the dentist Frederick McKay (1874–1959). McKay spent thirty years investigating the cause of what was then known as the Colorado brown stain, which produced mottled but also cavity-free teeth; with the help of G.V. Black and other researchers, he established that the cause was fluoride. The first report of a statistical association between the stain and lack of tooth decay was made by UK dentist Norman Ainsworth in 1925. In 1931, an Alcoa chemist, H.V. Churchill, concerned about a possible link between aluminum and staining, analyzed water from several areas where the
Water fluoridation
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school-based fluoride mouth-rinsing programme (S-FMR), with an estimate of 2,000,000 children participating in 2020. In 2005, the ruling Uri Party proposed legislation for compulsory water fluoridation for municipalities. The legislation failed, and only 29 out of around 250 municipal governments had introduced water fluoridation at that time. Fluoridation was proposed again in 2012. In 1998, 66% of Malaysians were getting fluoridated water. In 2010, Bernama reported, "Principal Director (Oral Health) in the Health Ministry, Datuk Dr Norain Abu Taib said that only 75.5% of the country's population are enjoying the benefits of water fluoridation". In 1956, Singapore was the first
Fluoridation by country
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was the only country in the European Union with a nationwide mandate for water fluoridation. The majority of drinking water is fluoridated. In 2012, roughly 3.25 million people received artificially-fluoridated water. Almost 71% of the population in 2002 resided in fluoridated communities. The fluoridation agent used is hydrofluorosilicic acid (HFSA; HSiF). In a 2002 public survey, 45% of respondents expressed some concern about fluoridation. In 1957, the Department of Health established a Fluorine Consultative Council which recommended fluoridation at 1.0 ppm of public water supplies, then accessed by approximately 50% of the population. This was felt to be a much
Fluoridation by country
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use terms such as "toxic" and "low grade chronic fluoride poisoning" to describe mottling from consumption of 6 mg/L of fluoride prior to tooth eruption, a level of consumption not expected to occur under controlled fluoridation. When voted upon, the outcomes tend to be negative, and thus fluoridation has had a history of gaining through administrative orders in North America. Conspiracy theories involving fluoridation are common, and include claims that fluoridation was motivated by protecting the U.S. atomic bomb program from litigation, that (as famously parodied in the film "Dr. Strangelove," where a deranged U.S. Army general claimed that it
Water fluoridation controversy
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of water fluoridation due to the introduction of fluoridated toothpaste in the 1970s and the large use of other fluoride-containing products, including mouthrinse, dietary supplements, and professionally applied or prescribed gel, foam, or varnish. For example, in Finland and Germany, tooth decay rates remained stable or continued to decline after water fluoridation stopped in communities with widespread fluoride exposure from other sources. Fluoridation is however still clearly necessary in the U.S. because unlike most European countries, the U.S. does not have school-based dental care, many children do not visit a dentist regularly, and for many U.S. children water fluoridation is
Water fluoridation
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substantial advantages, especially for subgroups at high risk, while the European Commission finds no benefit to water fluoridation compared with topical use. Public water fluoridation was first practiced in the U.S. 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. A further 28 countries have water that is naturally fluoridated, though in many of them the fluoride is above the optimal level. As of 2012, about 435 million people worldwide received water fluoridated at the recommended level (i.e., about 5.4% of the global population).
Water fluoridation
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no special advantage and prefer topical application strategies. Those opposed argue that water fluoridation has no or little cariostatic benefits, may cause serious health problems, is not effective enough to justify the costs, is pharmacologically obsolete, and presents a moral conflict between the common good and individual rights. Water fluoridation Water fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on tooth surfaces: in the mouth, it creates low
Water fluoridation
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They also found that many people found fluoridation to infringe upon personal liberty/freedom of choice by forcing them to be medicated, and that the long-term effects of fluoridation were insufficiently acknowledged. They also lacked a proper study on the effects of fluoridation on formula-fed infants. In the year 2004 the allowed amount of fluoride in the water was decreased to 1,5 mg/l. In Switzerland, since 1962, two fluoridation programs had operated in tandem: water fluoridation in the City of Basel, and salt fluoridation in the rest of Switzerland (around 83% of domestic salt sold had fluoride added). However it became
Fluoridation by country
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Fluoridation Act 2008. Several areas of Queensland, such as Julia Creek, Quilpie, Thargomindah and Adavale are known to have naturally occurring fluoride present in their drinking water, a characteristic that has been studied since the late 1920s. In 2009 an accident occurred at the North Pine treatment plant, and some homes received water having many times the recommended level of fluoride. Gladstone Regional Council has voted to remove fluoride from their water supply. Mackay council votes to remove fluoride from their water supply. Water fluoridation in Australia Australia is one of many countries that have water fluoridation programs currently operating
Water fluoridation in Australia
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While fluoridation can result in mild dental fluorosis, this effect is barely detectable and causes no concerns with the appearance or health of teeth. Countries practicing artificial water fluoridation vary in their recommended fluoride levels according to what health authorities in each have determined to be most effective for its citizens. The US recently reset the recommended optimal level of fluoride in drinking water, lowering it slightly, because of observed increased Fluorosis levels, likely due to additional fluoride sources like toothpaste and mouthwash which were not present when this level was originally set. Of Africa's 1.1 billion people, about 400,000
Fluoridation by country
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Fluoridation has little effect on risk of bone fracture (broken bones); it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation. There is no clear association between fluoridation and cancer or deaths due to cancer, both for cancer in general and also specifically for bone cancer and osteosarcoma. Other adverse effects lack sufficient evidence to reach a confident conclusion. Fluoride can occur naturally in water in concentrations well above recommended levels, which can have several long-term adverse effects, including severe dental fluorosis, skeletal fluorosis, and weakened bones; water utilities in the developed
Water fluoridation
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implement water fluoridation. The court soon issued a restraining order, but after half a year ULA withdrew its petition upon the request of the court. By 2011, about 65% of the municipalities and local authorities in Israel had agreed to allow fluoridation, and there was active opposition to the spread of fluoridation to the towns where it has not yet been instituted. In 2011, the Health and Welfare Committee of the Knesset criticized the Health Ministry for continuation of water fluoridation. On 26 August 2014, Israel officially stopped adding fluoride to its water supplies. According to a Ministry of Health
Fluoridation by country
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Other reviews have found not enough evidence to determine if water fluoridation reduces oral-health social disparities. Health and dental organizations worldwide have endorsed its safety and effectiveness. Its use began in 1945, following studies of children in a region where higher levels of fluoride occur naturally in the water. Further research showed that moderate fluoridation prevents tooth decay. Fluoridation does not affect the appearance, taste, or smell of drinking water. It is normally accomplished by adding one of three compounds to the water: sodium fluoride, fluorosilicic acid, or sodium fluorosilicate. These compounds were chosen for their solubility, safety, availability, and
Water fluoridation
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to be brought in state courts, a consensus developed that fluoridation, at least from a legal standpoint, was acceptable. In 1973's "Beck v. City Council of Beverly Hills", the California Court of Appeal, Second District, said, "Courts through the United States have uniformly held that fluoridation of water is a reasonable and proper exercise of the police power in the interest of public health. The matter is no longer an open question." Much of the contemporary debate on water fluoridation revolves around questions of how consumer demand for fluoride is determined and processed, which fluoridation costs and benefits are considered,
Water fluoridation in the United States
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When his colleagues balked, he pursued a referendum on the issue. On November 22, 1977, with a 28.3 percent turnout, 12,037 voters (53.6 percent) opposed a ban on fluoridation of the drinking water. Another 10,413 (46.4 percent) favored a ban. Though fluoridation was approved in a back-handed method—one had to vote "No" to approve of fluoridation—the physical process of actually placing the chemicals in the water supply, was not completed until the middle 1980s, long after Guin's tenure as utilities commissioner had expired. Guin served on the council with another Republican pioneer in Caddo Parish, George A. Burton, Jr., who
Billy Guin
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and Gabon. Community water fluoridation is rare in Continental Europe with 97–98% choosing not to fluoridate drinking water. Fluoridated salt and milk is promoted in some European countries instead. Water fluoridation has been replaced by other modes in many countries where water supplies are too decentralized for it to be a practical choice, or existing natural fluoride levels were already ample, including Germany, Finland, Japan, Netherlands, Sweden, Switzerland, Denmark and at a time Israel. Cessation of water fluoridation has been demonstrated in scientific studies such as a recent one in Calgary, Alberta, to result in increased rates of dental decay.
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as England. At issue was the most recent time-trend study of Dr. Burk and Dr. Yiamouyiannis, which compared cancer mortality in ten cities which fluoridated their water systems with ten cities which did not fluoridate over a period of twenty-eight years from 1940 to 1968. The study concluded that there was a significant increase in cancer mortality in the fluoridated cities." Judge Flaherty remained convinced that fluoridation is a dangerous practice based on the scientific evidence and moreover that those who belittle opponents of fluoridation do the public a disservice. However, like other judges, Judge Flaherty agrees that fluoridation is
John P. Flaherty Jr.
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Community water fluoridation is the addition of fluoride in the drinking water with the aim of reducing tooth decay by adjusting the natural fluoride concentration of water to that recommended for improving oral health. The NHMRC released the public statement of efficacy and safety of fluoridation 2007 to set the recommended water fluoridation to the target range of 0.6 to 1.1 mg/L, depending on climate, to balance reduction of dental caries (tooth decay) and occurrence of dental fluorosis (mottling of teeth). Moreover the public statement states that the fluoridation of drinking water is an effective way to ensure the community
Remineralisation of teeth
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Columbia (about 4%), and Newfoundland and Labrador (1.5%), with Nunavut and the Yukon having no fluoridation at all. Overall, about 45% of the Canadian population had access to fluoridated water supplies in 2007. A 2008 telephone survey found that about half of Canadian adults knew about fluoridation, and of these, 62% supported the idea. In 2010, the Region of Waterloo held a non-binding referendum for residents to decide whether water fluoridation should continue. The result of the vote was 50.3% voting against fluoridation. The regional council honored the vote, and over forty years of fluoridation in the city of Waterloo
Fluoridation by country
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as an infringement of individual rights, if not an outright violation of medical ethics, on the basis that individuals have no choice in the water that they drink, unless they drink more expensive bottled water. A small minority of scientists have challenged the medical consensus, variously claiming that water fluoridation has no or little cariostatic benefits, may cause serious health problems, is not effective enough to justify the costs, and is pharmacologically obsolete. Opposition to fluoridation has existed since its initiation in the 1940s. During the 1950s and 1960s, conspiracy theorists claimed that fluoridation was a communist plot to undermine
Water fluoridation controversy
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press release statement, the reasons it ended water fluoridation were: "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.). There is also scientific evidence that fluoride in large amounts can lead to damage to health. When fluoride is supplied via drinking water, there is no control regarding the amount of fluoride actually consumed, which could lead to excessive consumption. Supply of fluoridated water forces those who do not so wish to also consume water with added fluoride." Many in the medical and dental communities
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of Justice, Dries van Agt. The Netherlands has since then employed a distinction between hard and soft drugs. She also took the leading role in attempting to establish a legal basis for the fluoridation of drinking water. Though fluoridation to prevent tooth decay had been occurring in many areas across the Netherlands for years, the Supreme Court ruled in 1973 that it should be specifically provided for in the Water Supply law. Her bill to do so did not find support in the House of Representatives outside her own party, and was dropped. From 1978 until 1979 Vorrink was an
Irene Vorrink
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ended in November. In 2011, Calgary city council voted 10–3 to stop adding fluoride to the city's drinking water, having started water fluoridation in 1991. A research project has been planned to study the effects of Calgary's cessation, using Edmonton as a control. On 28 January 2013, Windsor city council voted 8–3 to cease fluoridation of Windsor's drinking water for five years, honoring a February 2012 recommendation by the Windsor Utilities Commission. Tecumseh gets its water from Windsor, and Tecmuseh's council had voted on 13 March 2012 to ask Windsor to stop fluoridating. Money formerly spent on fluoridation was reallocated
Fluoridation by country
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because unlike most European countries, the U.S. does not have school-based dental care, many children do not visit a dentist regularly, and for many U.S. children water fluoridation is the prime source of exposure to fluoride. The effectiveness of water fluoridation can vary according to circumstances such as whether preventive dental care is free to all children. Water fluoridation pits the common good against individual rights. Some say the common good overrides individual rights, and equate it to vaccination and food fortification. Others say that individual rights override the common good, and say that individuals have no choice in the
Water fluoridation controversy
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About 214 million of them living in the United States. Major health organizations such as the World Health Organization and FDI World Dental Federation supported water fluoridation as safe and effective. The Centers for Disease Control and Prevention lists water fluoridation as one of the ten great public health achievements of the 20th century in the U.S. Despite this, the practice is controversial as a public health measure. Some countries and communities have discontinued fluoridation, while others have expanded it. Opponents of the practice argue that neither the benefits nor the risks have been studied adequately, and debate the conflict
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on the most effective method for community prevention of tooth decay are mixed. The Australian government review states that water fluoridation is the most effective means of achieving fluoride exposure that is community-wide. The European Commission review states "No obvious advantage appears in favour of water fluoridation compared with topical prevention". Other fluoride therapies are also effective in preventing tooth decay; they include fluoride toothpaste, mouthwash, gel, and varnish, and fluoridation of salt and milk. Dental sealants are effective as well, with estimates of prevented cavities ranging from 33% to 86%, depending on age of sealant and type of study.
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published in the American trials on artificial water fluoridation. Sutton's analysis resulted in a 72-page monograph that questioned those studies' findings, and culminated in another publication, "Fluoridation: Errors and Omissions in Experimental Trials" in 1960 which included the responses of the trials authors' to the original critique and Sutton's comments. Sutton's other publications included studies on the relationship between mental stress and dental disease, the first appearing in the journal, Nature, in 1962. In 1979 he published another critique of water fluoridation studies, "Fluoridation 1979: Scientific Criticisms and Fluoride Dangers". His last book, "The Greatest Fraud: Fluoridation", was published posthumously
Philip R. N. Sutton
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(broken bones); it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation. There is no clear association between fluoridation and cancer or deaths due to cancer, both for cancer in general and also specifically for bone cancer and osteosarcoma. 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. Three such outbreaks were reported in the U.S. between 1991 and 1998, caused by fluoride concentrations as high as 220 mg/L; in the 1992 Alaska outbreak,
Water fluoridation controversy
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Water fluoridation Water fluoridation is the controlled addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on tooth surfaces: in the mouth, it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities. Typically a fluoridated compound is added to drinking water, a process that in the U.S. costs an average of about
Water fluoridation
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with guidelines set by provincial, territorial, and federal governments. Brantford, Ontario became the first city in Canada to fluoridate its water supplies in 1945. In 1955, Toronto approved water fluoridation, but delayed implementation of the program until 1963 due to a campaign against fluoridation by broadcaster Gordon Sinclair. The city continues to fluoridate its water today. In 2008 the recommended fluoride levels in Canada were reduced from 0.8–1.0 mg/L to 0.7 mg/L to minimize the risk of dental fluorosis. Ontario, Alberta, and Manitoba have the highest rates of fluoridation, about 70–75%. The lowest rates are in Quebec (about 6%), British
Fluoridation by country
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cheaper way of improving the quality of children's teeth than employing more dentists. This led to the Health (Fluoridation of Water Supplies) Act 1960, which mandated compulsory fluoridation by local authorities. The statutory instruments made in 1962–65 under the 1960 Act were separate for each local authority, setting the level of fluoride in drinking water to 0.8–1.0 ppm. The current regulations date from 2007, and set the level to 0.6–0.8 ppm, with a target value of 0.7 ppm. Implementation of fluoridation was held up by preliminary dental surveying and water testing, and a court case, Ryan v. Attorney General. In
Fluoridation by country
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administration are dealt with by the Advisory Committee for the Fluoridation of Public Water Supplies. Water fluoridation commenced in Adelaide in 1971. There is no legal requirement to add fluoride to drinking water supplies. As of 2010, 90% of the state’s communities have access to reticulated water with appropriate levels of fluoride. Fluoride has been added to public water supplies in Darwin (since 1972), Katherine, and Gove. Similarly to South Australia, there is no legal requirement to add fluoride to the Northern Territory's water supplies, but a position paper published in November 2010 strongly encourages water providers to add fluoride
Water fluoridation in Australia
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get artificially-fluoridated water (in Libya, data pre-2003). Water is fluoridated in Egypt, with no recommended minimum value but with a maximum value of 0.4 mg/L. Before 2003, 400,000 Libyans were receiving artificially-fluoridated water. Only a fraction of Nigerians receive water from waterworks, so water fluoridation affects very few people. A 2009 study found that about 21% of water sources naturally contain fluoride to the recommended range of 0.3–0.6 ppm. About 62% have fluoride below this range. South Africa's Health Department recommends adding fluoridation chemicals to drinking water in some areas. It also advises removal of fluoride from drinking water (defluoridation)
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many clinical trials were conducted Following these studies, the recognition of the positive outcome on dental tissues became clear and projects in water fluoridation became of significant importance. The development of artificial water fluoridation began in 1945 in the Grand rapid Michigan followed by Newburgh, New York and Evanston, Illinois. In 1955 three towns Watford, Kilmarnock and Anglesey trialled the water fluoridation implementation scheme. In 1960 the Republic of Ireland implemented all public water supplies with artificial fluoridated water and four years later extending this into the main cities of Dublin and Cork. Currently, 40 countries have fluoridated water schemes
Dental public health
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Development and Innovation. Prior to this legislation Queensland was the only Australian state without a formal statewide program for the addition of fluoride to drinking water. The accompanying Water Fluoridation Regulation 2008 listed 134 drinking water supplies that were to be fluoridated by 31 December 2012. Of the drinking water supplies listed in the Regulation, 32 comprised the SEQ Water Grid located in Southeast Queensland. The fluoridation of these supplies by the end of 2009 accounted for the largest increase in people currently receiving fluoridated water in Queensland (approximately 2.6 million people in 2006 or 68% of the Queensland population).
Water fluoridation in Australia
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Some areas within Australia have natural fluoride levels in the groundwater, which was estimated in 1991 to provide drinking water to approximately 0.9% of the population. A key difference between the implementation of drinking water fluoridation in the United States and Australia was the impact of temperature and climate on water consumption. Temperatures are a key factor in the establishment of legislative requirements, such as the Water Fluoridation Regulation 2008 in Queensland, that prescribe concentrations of fluoride to be added to the water. Consequently, areas with higher average temperatures require less fluoride to be added to the drinking water to
Water fluoridation in Australia
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has always been 100% during the times in which it was added. Water fluoridation was introduced in Western Australia in Perth in 1968, and is regulated by the Fluoridation of Public Water Supplies Act 1966. As of 2012, around 92% of the population is provided with fluoridated water through a drinking water supply. An exception exists in the Busselton, Vasse and Wonnerup townsites (approximately 20,000 residents), where fluoride is not artificially added to the water because it has naturally occurring fluoride. Proposals for the addition of fluoride to a public water supply or matters relating to the Act and its
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and attended by councillors, and on 5 June 2013, the city council voted 7–1 (with five abstentions) to cease water fluoridation. The council wrote to Minister of Health Tony Ryall requesting that, as a health issue, water fluoridation be decided by the national government. The cost of water fluoridation was estimated by the city council as $48,000 per year. On election day, the referendum result was welcomed by both the chief executive and Medical Officer of Health of the Waikato District Health Board. As the referendum was not binding, a council vote was required to restart fluoridation. On 28 November
2013 Hamilton local elections and referendums
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one of the first cities in Europe to fluoridate its water supply. It was declared illegal by the Supreme Administrative Court of Sweden in 1961, re-legalized in 1962 and finally prohibited by the parliament in 1971, after considerable debate. The parliament majority said that there were other and better ways of reducing tooth decay than water fluoridation. Four cities received permission to fluoridate tap water when it was legal. An official commission was formed, which published its final report in 1981. They recommended other ways of reducing tooth decay (improving food and oral hygiene habits) instead of fluoridating tap water.
Fluoridation by country