Community Water Fluoridation Essay

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Introduction
Community water fluoridation is the process of regulated supplementation of fluoride to public water supplies in order to reduce the prevalence of dental caries (1). World Oral Health Report 2003 identified dental caries as a key public health issue in a majority of industrialized countries, where 60-90% of schoolchildren and the majority of adults are affected (2). The World Health Organization recognizes water fluoridation as one of the most cost-effective methods of distributing fluoride to a large population (3). However, fluoridation remains unavailable to numerous communities around the world, where only 435.1 million individuals worldwide have access to water supplies which are fluoridated at the optimal level (4).
A systematic review of water fluoridation by McDonagh and his team demonstrated the effectiveness of fluoridation in terms of caries reduction and the risk of dental fluorosis (5). However, opponents of fluoridation have raised various concerns regarding the potential harms
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Dental fluorosis is the most extensively investigated adverse effect concerning water fluoridation. The McDonagh review examined 88 studies in order to determine the correlation between water fluoridation and dental fluorosis (5). The authors divided the results into two categories: 1) any-fluorosis-–any degree of fluorosis on any fluorosis scale, and 2) fluorosis-of-aesthetic-concern-–-> 3 on Thylstrup-Fejerskov index, mild on the Dean’s-index, or > 2 on the Total-Surface-Index-of-Fluorosis-scale. The number-needed-to-harm (NNH) for any fluorosis was 6, whereas NNH for fluorosis of aesthetic concern was 22. Furthermore, evidence suggests a direct relationship between severity of dental fluorosis and fluoride concentration. Moreover, the majority of reported dental fluorosis was not of aesthetic

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