An update on water fluoridation: triumphs and challenges.

This paper encompasses information on the status of community and school water fluoridation in the U.S. and abroad, the status and action on State fluoridation .laws, an explanation and effect of the Safe Drinking Water Act, dental benefits, and identification and refutation of the three most common areas of allegations against fluoridation. Grand Rapids that same year to demonstrate that the dental benefits, discovered through extensive epidemiological resea~rch in naturally fluoridated communities , could be replicated by man through the upward adjustment of the fluoride content in the water. By the end of 1975, the last time a nationwide fluoridation census was taken, it was estimated that slightly more than 105,000,000 people in the U.S. had access to water fluoridated at optimum (0.7-1.2 ppm depending on the climate), or higher levels. ~ This included approximately 10,000,000 people whose water supplies are naturally fluoridated at 0.7 ppm or higher. About 60% of the population who have access to public water supplies, or 50% of the total population, had fluoridated water. Since that time, the natural population growth, the fluoridation of the Boston area, and numerous small communities have increased the number benefiting from fluoridation to at least 108,000,000. The magnitude of the problem of extending fluoridation universally is perhaps best emphasized by the fact that this 50% of the total population is served by only about 13% of the community water supplies. Thus, to reach the last half of the population who are served by community water supplies, some 87% of the water supplies still need to be fluoridated. There are great variations in the location and size of the communities which are fluoridating. Based on the 1975 fluoridation census, 22 states, the District of Columbia, and Puerto Rico provided fluoridated water to more than half of their population. In comparison, states in the western third of the country, the Deep South and New England, and the state of New Jersey have been particularly slow in adopting fluoridation. Over 9,000 areas had fluoridated water: 6,795 adjusted and 2,630 natural. Approximately 70% of all cities having a population of 100,000 or more are fluoridated. The vast majority of communities which are not fluoridated have populations of less than 25,000. It is estimated that these are served by over 50,000 community water systems. The duration of the experience with adjusted fluoridation is impressive. At last count 108 cities with populations of 50,000 or …