Fluoride
Water Fluoridation- Facts, Figures and Frequently Asked Questions
Background: Many public health agencies and experts endorse adding fluoride to the water as an effective method of preventing tooth decay in communities where natural fluoride levels are low. The “optimal” concentration range of fluoride in drinking-water for preventing tooth decay was set at a range of 0.7 to 1.2 mg/L over 40 years ago by the U.S. Public Health Service, though they revised this range to the single value of 0.7 mg/L in January 2011, in recognition of the increasing prevalence of fluoride exposure from other sources (such as toothpastes and processed beverages),
According to the U.S. Centers for Disease Control and Prevention (CDC) in 1999, the fluoridation of drinking water is considered to be one of the ten greatest achievements in public health in the 20th Century, as studies have shown that fluoride prevents the formation of, slows the progression of, and can even reverse newly-formed dental cavities.
The CDC published its report on fluoride in 2001 (Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States, MMWR August 17, 2001 50(RR14);1-42) which summarized the following:
Fluoride’s ability to inhibit or even reverse the initiation and progression of tooth decay is well documented. The first use of adjusted fluoride in water for tooth decay control began in 1945. In 1946 the US and Canada conducted studies in four communities to compare the prevalence of dental decay in communities with fluoridation to communities without fluoridation. The studies revealed a significant decrease in dental decay in fluoridated communities.
The U.S. Public Health Service (PHS) developed recommendations in the 1940s and 1950s regarding fluoride concentrations in public water supplies. At that time, public health officials assumed that drinking water would be the major source of fluoride for most U.S. residents.
The success of water fluoridation in preventing and controlling tooth decay led to the development of fluoride-containing products, including toothpaste (i.e., dentifrice), mouth rinse, dietary supplements, and professionally applied or prescribed gel, foam, or varnish.
The CDC also stated that:
• Fluoride works primarily after teeth have emerged, especially when small amounts are maintained constantly in the mouth through dental plaque and saliva, meaning adults also benefit from fluoride, not just children
• Widespread fluoride use has been a major factor in declining tooth decay in the United States and other developed countries
• Frequent exposure to small amounts of fluoride each day best reduces tooth decay risk for all age groups
Finally, the CDC summarized the following:
• Widespread use of fluoride has been a major factor in the decline in the prevalence and severity of dental cavities (i.e., tooth decay) in the United States and other economically developed countries.
• When used appropriately, fluoride is both safe and effective in preventing and controlling tooth decay.
• All U.S. residents are likely exposed to some degree to fluoride, which is available from multiple sources.
Because frequent exposure to small amounts of fluoride each day will best reduce the risk for tooth decay in all age groups, the work group recommends that all persons drink water with an optimal fluoride concentration and brush their teeth twice daily with fluoride toothpaste. For persons at high risk for tooth decay, additional fluoride measures might be needed.
The American Water Works Association (AWWA) supports the recommendations of the World Health Organization (WHO), American Medical Association (AMA), Canadian Medical Association (CMA), Centers for Disease Control and Protection (CDC), American Dental Association (ADA), Canadian Dental Association (CDA),American Academy of Pediatrics (AAP) and other professional organizations in the medical community, for the fluoridation of public water supplies as a public health benefit.
AWWA supports the application of fluoride in a responsible, effective, and reliable manner that includes monitoring and control of fluoride levels mandated by provincial, state, and/or federal laws, and that it is subject to community acceptance through applicable local decision-making processes. AWWA is committed to regular reviews of the most current research on fluoride and the positions of the medical and dental communities.
Albany’s Fluoridation project
The Albany Water Department (AWD) will begin adding fluoride to the water supply system later this year (2025).
Water Fluoridation will be in compliance with the Local Law K of 2023 (Article IX of the City Code), and under permit provisions of the NYS Department of Health at a concentration of 0.7 milligrams per liter (mg/L).
Fluoride will be added during water treatment. AWD will use fluorosilicic acid in the treatment of its water since it is a high purity source of fluoride. This chemical meets strict National Science Foundation International standards for use in potable water.
AWD has operators and chemists at its treatment facilities 24/7 to constantly monitor the level of fluoride that is being added to the water.
The total project cost for the addition of Fluoride to drinking water is $1,447,316. (Engineering - $371,590 and Construction - $1,075,726). Sources of funds for the project are $1.0 million from Drinking Water Fluoridation grant from the NYS Department of Health and the balance of funds from the Albany Water Board’s “On-going Projects” fund, a capital reserve account.
Annual Operation & Maintenance Costs are estimated to be approximately $81,000, which include chemical costs and costs associated with maintenance of chemical feed pumps. Costs of the fluoride chemical is based on the current price of $4.39/gallon. Dosage will be 50 gallons per day. The cost to add fluoride impact to the average water bill is less than $1/year.
A question has been raised concerning preventing an overfeed of fluoride chemical to avoid dosing greater than 0.7mg/l of Fluoride in the finished water leaving the treatment plant.
The chemical feed pumps will be flow-paced and controlled by an online fluoride residual monitor. The day tank level will be monitored using a scale (weight) and the depth (radar sensor). Both levels will be calculated in SCADA (our monitoring control system) and displayed adjacent to the tank. If the calculated levels vary by more than 5%, the system will issue an alarm to have the devices checked and re-calibrated. If the system detects that the drop in level in the day tank (measured from either instrument) is dropping at a rate that exceeds the projected rate needed to achieve a 0.7 mg/L dose, the chemical metering pumps shall be stopped, and the system will issue an alarm for a potential over-feed situation. The treatment plant is staffed 24/7 and plant operators conduct hourly checks on all critical operating parameter
For more information on community water fluoridation, please visit https://www.cdc.gov/fluoridation/faq/index.html