Expert points out need for fluoride in city water

Aberdeen City Council invited a Registered Dental Hygienist (RDH) to explain why fluoride is important to the city's water supply.

Shelley Guinn, Oral Health Program Manager for the Washington State Department of Health, talks about the role of fluoride, its effects on teeth and other parts of the body, and the historical consequences of fluoride deficiency.

After speaking for about 30 minutes, Gene appeared to address any potential concerns about fluoride in the city's water, in addition to a question posed by one city council member.

Guinn's career revolved around dental health, including 15 years as a clinical hygienist in private practice, followed by 10 years “developing and managing projects to create access to dental services for disadvantaged populations.

Guinn immediately explained several points about fluoride. Here are some salient points.

“No. 1. Fluoride occurs naturally in all water,” Gene said. “No. 2. Adding fluoride means adjusting the fluoride content. This amount can be increased or decreased appropriately to prevent tooth decay and benefit health.

These perspectives led her to explain a huge problem and how fluoride can help stop it.

“Tooth decay is the most common chronic disease on earth,” Gene said. “It begins as the most common chronic disease in childhood. Treatment is extremely expensive, but it is preventable.

Preventing disease is always the best approach, Jean said.

“Dental caries is the name for the disease that causes cavities in teeth, which we call cavities, and this is no exception,” Gene said. “This is a disease that, once it develops, must be managed throughout the individual's life.”

Tooth decay can cause many problems, including:

• pain

• uncomfortable

• Infection (abscess)

• Poor performance in school and work

• self-abasement

Rot can also cause difficulties with:

• Diet

• Speaking

• Smile

• sleep

• Talk to others

• looking for a job

Cost is a big issue for many people. Getting dental care isn't always easy. Without dental insurance, this is a more serious problem.

“(The Centers for Disease Control) reports that for every adult without health insurance, there are three without dental insurance,” Ginn said. “The Affordable Care Act does not provide for adult dental care. But in Washington, we do provide comprehensive dental benefits to people who have Medicaid as their insurance.

According to Gene's sideshow, tooth decay is “the most common reason uninsured people in Washington go to the emergency room.”

In addition to the cost of “dental-related emergency room” visits (more than $36 million in 18 months), there are other issues, such as:

“Oral infections are associated with and can worsen systemic diseases such as diabetes, heart disease, and aspiration pneumonia.

Before water fluoridation

Jean offers a grim analysis of life before water fluoridation, including:

• The average school child develops three to four new cavities each year.Removal of permanent teeth is common in young children

• A new bride’s trousseau “sometimes” includes dentures

• 10% of World War II recruits were rejected because they did not have six pairs of contact teeth

• In the 1940s, high school graduates received complete dentures as gifts

• Full tooth extractions and complete dentures are normal for adults


Washington State Revised Code 43.20.050 requires the State Board of Health to adopt necessary rules for Class A public water systems to ensure “safe and reliable drinking water and protect the public health.” These regulations, such as WAC Chapters 246-290, which set standards for water systems, require testing and certification.

“The Department of Health supports community water fluoridation as a sound, population-based public health measure,” Jean's slide states. “Community water fluoridation is a proven public health prevention measure that benefits children and adults regardless of age, race, gender, or income. The Department encourages communities to initiate and maintain optimal fluoridation in drinking water systems chemical levels to benefit health.

Recognized by the scientific community

According to Ginn's slides, there is a long list of organizations that “recommend fluoridating public water systems and recognize the public health benefits.” The list includes:

• American Water Works Association (AWWA)

• World Health Organization (WHO)

• American Medical Association (AMA)

• Canadian Medical Association (CMA)

• Centers for Disease Control (CDC)

• American Dental Association (ADA)

• Canadian Dental Association (CDA)

Although Jean's slides were evidence-based, the City Council raised a question. This was proposed by Aberdeen Ward 4 Councilor Riley Carter.

Gene's answer was clear.

“It's understandable why you ask,” Gene said. “We need fluoridated water as well as fluoride in toothpaste. Let me explain why. Fluoride in toothpaste provides a temporary, higher dose of fluoride that just stays in your mouth until you remove it. Spit it out…and when we drink water that contains fluoride, it does get into our saliva, so it does help stay in our teeth the number of times we drink the water. More than brushing your teeth, hopefully you drink water from the faucet so you feel like you're flushing every time you drink, that little dose – a little bit of fluoride on your enamel, and… …even smaller amounts may pass through your salivary glands.

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