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MyView: Be proactive: Do your part to protect oral health by advocating water fluoridation

January 02, 2012

By Leon Stanislav, D.D.S.

Great strides have been made over the last several decades to increase community water fluoridation (CWF) nationwide. The goal of Healthy People 2010 was 75 percent. Throughout the nation, we are nearly 73 percent today.

As chair of the National Fluoridation Advisory Committee from 2007-10 and the immediate past president of the Tennessee Dental Association, I’ve watched how local and state initiatives affecting community water fluoridation have played out across the country. What I’ve learned is that it pays to be proactive in order to continue to grow the numbers of communities with fluoridation.

Tennessee has always been one of the leaders in the nation with 96 percent or better at one time. That figure is, however, eroding. We are down in the low 90s now with more communities being challenged every day by opponents to CWF.

There are many reasons, but cost is being raised as one of the bigger issues in these economic times. This is short-sighted with expenses only amounting to 50 cents to $3 per year per person, while oral health care cost savings average $38 per every dollar spent on CWF. In a recent example, Spring Hill, Tenn., aldermen made note of the $21,000 spent to add fluoride. While this is only pennies per month for each individual, it can mean health care related cost savings of nearly $800,000 for the citizens of that community.

The Tennessee Dental Association sponsored legislation this past year that requires utility districts that are about to initiate or cease fluoridation to contact the health department within 10 days of the decision, and the public must be given notice 30 days prior to such action. Additionally, consumers can check on the status of their drinking water by going to the Centers for Disease Control and Prevention website, "My Water’s Fluoride," check the Consumer Confidence Report provided annually by the water utility or check with the local health department.

However, it is not enough to assume there are no efforts to change the practice of CWF in your community just because it is currently fluoridated. Many efforts by antifluoridationists are started well in advance of any official action by the city or utility district. It is important that you develop relationships with your city and state policymakers. Not just because of CWF but all agendas of interest that might affect your life and your dental practice.

When you visit with them, ask that you be fairly informed if discussions about water fluoridation are mentioned publicly or privately. Be prepared to form coalitions with your local dental group, pediatric physicians, nurses and other health care providers. Many Tennessee counties already have in place health councils such as the Montgomery County Health Council in Clarksville that has many participating allied professionals who meet on a monthly basis. Program directors from the Women, Infants and Children Program and other agencies are often members. These people can be great allies.

Opponents to fluoridation are educating themselves with a great deal of misinformation, much of which is found on the Internet. It might be beneficial to see what the opposing arguments are by checking sites such as the Fluoride Action Network. Then, educate yourselves with true science and true data on the ADA website, I like my teeth and finally, another site that is accumulating legal and legislative data is the FLUID site, Fluoride Legislative User Information Database, at fluid law.

In short, don’t be complacent—be proactive. Once citizens in opposition and policymakers have had time to prepare without hearing both sides, it can be very difficult to catch up or overturn a voter on this issue. Don’t take community water fluoridation for granted! Let’s continue to grow the numbers of utilities with fluoride and stop the attrition by those who have it. It is still the most cost-effective way to prevent tooth decay in all age groups crossing all socioeconomic boundaries.

Dr. Stanislav is one of the dental profession’s expert consultants on fluoridation. His comments, reprinted here with permission, originally appeared in the October 2011 issue of the TDA Newsletter.

Editor’s note: The ADA offers a number of resources to assist members and health coalitions in their efforts to support community water fluoridation. For more information, visit or contact Jane McGinley at or Ext. 2862.