Water fluoridation is the addition of controlled fluoride to the public water supply to reduce tooth decay, and is handled differently by country. Fluoridated water has fluoride at an effective level to prevent cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on the tooth surface: inside the mouth it creates low levels of fluoride in the saliva, which reduces the rate at which tooth enamel destroys and increases the rate at which it remineralizes at an early stage of the cavity. Usually fluoride compounds are added to drinking water, a process that in the US spends an average of about $ 1.06 per person per year. Defluoridation is required when naturally occurring fluoride levels exceed the recommended limits. In 2011, the World Health Organization recommended a fluoride level of 0.5-1.5 mg/L (milligrams per liter), depending on climate, local environment, and other sources of fluoride. Bottled water usually has unknown levels of fluoride.
Dental caries remains a major public health problem in most industrialized countries, affecting 60-90% of schoolchildren and most adults. Water fluoridation reduces cavities in children, while efficacy in adults is less clear. A Cochrane review estimates a reduction in cavities when water fluoridation is used by children who do not have access to other sources of fluoride to 35% in baby teeth and 26% in permanent teeth. Most European countries have experienced a major decline in tooth decay without its use. Recent studies have shown that water fluoridation, particularly in industrialized countries, may not be necessary because topical fluoride (such as toothpaste) is widely used and caries levels are low.
Although fluoridation can cause dental fluorosis, which may alter the appearance of developing teeth or enamel fluorosis, the difference is mild and is usually not considered an aesthetic or public health problem. There is no clear evidence of any other adverse effects of water fluoridation. The 2007 Australian systematic review used the same inclusion criteria as the York criteria, plus one additional study. This did not affect York's conclusions. The fluoride effect depends on the total daily intake of fluoride from all sources. Drinking water is usually the largest source; Other fluoride therapy methods include fluoridation of toothpaste, salt, and milk. The views on the most effective methods for prevention of tooth decay communities vary. The Australian Government states that water fluoridation is the most effective way to achieve community fluoride exposure. The World Health Organization states that water fluoridation, when feasible and culturally acceptable, has substantial benefits, especially for high-risk subgroups, while the EC finds no advantage over water fluoridation compared with topical use.
Currently around 372 million people (approximately 5.7% of the world's population) receive fluoride-made water in about 24 countries, including Australia, Brazil, Canada, Chile, Ireland, Malaysia, USA and Vietnam. With 57.4 million people receiving natural fluoride water at or above the optimal level in countries such as Sweden, China, Sri Lanka, Finland, Zimbabwe and Gabon. Fluoridation of rare public water on the Continent of Europe with 97-98% chooses not to fluoridate drinking water. Fluorinated salt and milk are promoted in several European countries instead. Fluoridation of water has been replaced by other modes in many countries where water supply is too decentralized as it becomes a practical choice, or natural fluoride levels are sufficient, including Germany, Finland, Japan, the Netherlands, Sweden, Switzerland, Denmark and in Israel. The discontinuation of water fluoridation has been demonstrated in scientific studies such as that recently in Calgary, Alberta, to produce an increased level of tooth decay. While fluoridation can produce mild tooth fluorosis, this effect is virtually undetectable and does not cause concern on appearance or dental hygiene. Countries that practice artificial fluoridation vary in the recommended fluoride levels according to what each health authority has decided to be most effective for its citizens. The US recently reorganized the optimal fluoride levels suggested in drinking water because of observed Fluorosis levels, probably because additional fluoride sources such as toothpaste and mouthwash are not present when this level is initially established.
Video Fluoridation by country
Africa
Of the 1.1 billion Africans, about 400,000 received fluoride-made water (in Libya, pre-2003 data).
Egypt
Water is fluoridated in Egypt, without the recommended minimum value but with a maximum value of 0.8 mg/L.
Libya
Before 2003, 400,000 Libyans received artificial fluoride water.
Nigeria
Only a small proportion of Nigerians receive water from aqueducts, so water fluoridation affects very few people. A 2009 study found that about 21% of water sources naturally contain fluoride up to the recommended 0.3-0.6 ppm range. About 62% have fluoride below this range.
South Africa
The South African Department of Health recommends adding fluoride chemicals to drinking water in some areas. It also suggests the removal of fluoride from drinking water (defluoridation) in which the fluoride content is too high.
Legislation surrounding fluoridation must be introduced in 2002, but has been delayed since then awaiting further research after opposition from water companies, municipalities and communities.
Zambia
Approximately 947,000 (7% of the population) receive water with naturally occurring fluoride in it.
Zimbabwe
About 2,600,000 (21% of the population) receive water with naturally occurring fluoride in it.
Maps Fluoridation by country
Asia
China
Fluoridation is prohibited in China. High fluoride levels in water are a serious problem in China. In 2003, there was no fluoridation of water in China. Fluoridation of water began in 1965 in the urban area of ​​Guangzhou. It was disrupted during 1976-1978 due to a lack of sodium silico-fluoride. It only continued in the city's Fangcun district, due to objections, and was terminated in 1983. Fluoridation reduced the number of cavities, but increased dental fluorosis; fluoride levels may have been set too high, and low quality equipment leads to inconsistent, and often excessive fluoride concentrations.
Hong Kong
All Hong Kong residents receive natural fluoride in water, about half of the recommended fluoride levels. The Water Supply Department fluidized rainwater from 17 local reservoirs, at 21 processing plants. The latest tests show that drinking water has an average fluoride level of 0.48 mg/L, and a maximum of 0.69 mg/L.
India
Fluoridation of water is not done in India. Due to the naturally occurring fluoride, both bone and tooth fluorosis have been prevalent in India in at least 20 countries, including Uttarakhand, Jharkhand and Chhattisgarh. The maximum limit of fluoride allowed in drinking water in India is 1.2 mg/L, and the government has an obligation to install a fluoride removal plant of various technologies to reduce fluoride levels from industrial waste and mineral deposits. Now the reverse osmosis plant is widely used. Household and general household reverse osmosis systems are found in the market. Alleppey in Kerala is most affected by too fluoridated water. Government-supplied reverse osmosis installation provides free filter water. Rotary International Club, Saratoga USA, helps to install 3 RO Crops in Alleppey countryside.
By 2014, there are 14,132 shelter in 19 Countries that still contain fluoride above the levels allowed in drinking water. Rajasthan has the highest number of shelters (7,670) with high amounts of fluoride in drinking water. Telangana has 1174, Karnataka has 1122 and Madhya Pradesh has 1055 dwellings. Assam, Andhra Pradesh, Bihar, Chhattisgarh, Maharashtra, Odisha, West Bengal, and Uttar Pradesh also have such places.
The Government of India launched the National Program for Fluorosis Prevention and Control in 2008-2009. In 2013-2014, the program is brought under the National Rural Health Mission, which so far covers 111 districts. The program includes surveillance of fluorosis in the community, training and labor support, the establishment of diagnostic facilities, treatment and health education. The Indian Medical Research Council has established a task force on fluorosis to address the problems associated with prevention and control.
Israel
Fluoride was required in the national water supply by law passed in 2002, but the requirement was revoked in 2014, and artificial fluoridation was undermined by national health officials, effectively ending practice in Israel for a while. After the 2015 election the fluoridation program will be debated again the new Deputy Health Minister Yaakov Litzman.
Mekorot, Israel's national water company states, "In the South of the country, there is no need to add fluorine because it is found naturally in the water." Water fluoridation was introduced in major Israeli cities in 1981, and a national effort to fluoridate all of the country's water was approved in 1988.
In 2002, the Union of Local Authorities (ULA) and others petitioned the Israeli High Court to stop the Health Ministry from forcing cities to apply water fluoridation. The court immediately issued a restraining order, but after half a year the ULA withdrew its petition at the request of the court.
In 2011, about 65% of municipalities and local governments in Israel have agreed to allow fluoridation, and there is active opposition to the spread of fluoridation to cities where it has not been institutionalized. In 2011, the Knesset Health and Welfare Committee criticized the Department of Health for continuing water fluoridation.
On August 26, 2014, Israel officially stopped adding fluoride to its water supply. According to a press release from the Department of Health, the reason why fluoridated water ends is: "Only 1% water is used for drinking, while 99% of water is used for other purposes (industry, agriculture, flushing toilet, etc.) There is scientific evidence that fluoride in quantity large amounts can cause damage to health When fluoride is supplied through drinking water, there is no control over the amount of fluoride actually consumed, which can lead to excessive consumption of water forcing those who do not really want to also consume water with the addition of fluoride. "Many in the medical and dental community in Israel criticized the decision as a mistake.
After the 2015 election, the new deputy Health Minister Yaakov Litzman announced that the fluoridation program would be debated again.
Japanese
The first community water fluoridation program was in Kyoto Prefecture in 1952, which lasted 13 years. The second was founded by US military authorities in Okinawa Prefecture in 1957, which lasted for 15 years. The last experience was in Mie Prefecture in 1967, which lasted for 4 years.
Less than 1% of Japanese practice water fluoridation. In exchange, in March 2010, a total of 7,479 schools and 777,596 preschools for junior high school children participated in a school-based fluoride extension program (S-FMR), with an estimated 2,000,000 children participating in 2020.
South Korea
In 2005, the Powerful Party of Power proposed a law for mandatory fluoridation water for the municipality. The law failed, and only 29 of about 250 municipalities introduced fluoridation at that time. Fluoridation is proposed again in 2012.
Malaysia
In 1998, 66% of Malaysians had fluoride water.
In 2010, Bernama reported, "President Director (Oral Health) at the Ministry of Health, Datuk Dr Norain Abu Taib said that only 75.5% of the country's population enjoys the benefits of water fluoridation".
Singapore
In 1956, Singapore was the first Asian country to institute a water fluoridation program covering 100% of the population. Air fluoride with a typical value of 0.4-0.6 mg per liter.
Vietnamese
Only about 4% of Vietnam's population has water fluoridation, whereas only 70% get their water from public supplies.
Europe
Of the population of about three quarters of a billion, under 14 million people (about 2%) in Europe receive fluoride-made water. The men were in England (5,797,000), the Republic of Ireland (3.250.000), Spain (4.250.000), and Serbia (300,000).
The first water fluoridation in Europe was in West Germany and Sweden in 1952, bringing fluoridated water to about 42,000 people. By mid-1962, about 1 million Europeans in 18 communities in 11 countries received fluoridated water.
Many European countries have rejected water fluoridation, including: Austria, Belgium, Finland, France, Germany, Hungary, Luxembourg, Netherlands, Northern Ireland, Norway, Sweden, Switzerland, Scotland, Iceland and Italy. A 2003 survey of more than 500 Europeans from 16 countries concluded that "most people are against water fluoridation".
Austria
Austria never applied fluoridation.
Belgium
Belgium did not give fluoridation of its water supply, even though the law allowed it.
Czech Republic
The Czech Republic (formerly Czechoslovakia) initiated water fluoridation in 1958 at TÃÆ'¡bor. In Prague fluoridation began in 1975. It was stopped in Prague in 1988 and later across the country. Since 2008 there has been no water in fluoridation. Fluoride salt is available.
Croatian
Croatia does not make its water fluoride.
Denmark
Denmark has released test results for various levels of water contaminants, including fluoride, in drinking water in several cities: KÃÆ'¸benhavn, BrÃÆ'¸ndby, Albertslund, DragÃÆ'¸r, Hvidovre, RÃÆ'¸dovre, VallensbÃÆ'Â|k, and Herlev.
Estonian
There is no water fluoridation in Estonia. About 4% of the population may be exposed to excessive fluoride in drinking water, and there are steps to eliminate excess fluoride.
Finnish
Kuopio is the only community in Finland with at least 70,000 people who have had water fluoride. Kuopio stopped fluoridation in 1992. In areas with rapakivi rocks (small areas, but densely populated), 22% of well water and 55% of drilled waters exceeded the legal limit of 1.5 mg/l; Generally, surface and well water have 0.5-2.0 mg/l fluoride in the affected area.
French
Fluoride salts are available in France, and 3% of the population uses natural fluoride water, but the water does not fluoridate artificially.
German
Current public drinking water supplies do not fluoride anywhere in Germany, but for children and adolescents using fluoridated salt and toothpaste, and fluoride and washing tablets are highly recommended by the German Ministry of Health.
Kassel-Wahlershausen in West Germany became the second location in Europe where water fluoridation was practiced in 1952. In 1962, no other part of FRG was fluoridated, and Kassel-Wahlershausen stopped the practice in 1971.
In the GDR (East Germany) in the late 1980s, approximately 3.4 million people (20%) received water with additional fluoride. Fluoride tablets are also provided. The fluoride areas of the GDR include the towns of Karl-Marx-Stadt (now Chemnitz), Plauen, Zittau, and Spremberg. Children in those cities are part of a major research on caries prevalence. Fluoridation of water was stopped after German reunification.
Greek
There is no water fluoridation in Greece.
Hungarian
In the early 1960s, the city of Szolnok briefly fluidized its water. The program was discontinued due to technical problems and the general view that fluoridation does not seem to make sense. Hungary has not used artificial fluoridation water ever since.
ireland
By the end of 2015, Ireland is the only country in the European Union with a national mandate for water fluoridation.
The majority of drinking water is fluoride. In 2012, approximately 3.25 million people receive artificial fluoride water. Almost 71% of the population in 2002 lived in the fluoride community. The fluoridation agent used is hydrofluorosilicic acid (HFSA; H 2 SiF 6 ). In a public survey in 2002, 45% of respondents expressed concern about fluoridation.
In 1957, the Ministry of Health established a Fluor Consultation Council recommending fluorization at 1.0 ppm of public water supply, then accessed by about 50% of the population. This is perceived as a much cheaper way to improve the quality of children's teeth than to hire more dentists. This led to the 1960 Health Act (Fluoridation of Water Supply), which required compulsory fluoridation by local authorities. The legal instruments created in 1962-65 under the separate 1960 Act for each local authority, set the level of fluoride in drinking water to 0.8-1.0 ppm. The current regulatory date is from 2007, and set the level to 0.6-0.8 ppm, with a target value of 0.7 ppm.
The implementation of fluoridation is sustained by dental surveys and initial water testing, and court cases, Ryan v. Attorney General. In 1965, the Supreme Court rejected Gladys Ryan's claim that the Act violates the Irish Constitution which guarantees the right to body integrity. In 1965, Greater Dublin water had been in fluoridation; in 1973, other urban centers as well. Studies from the late 1970s to mid-1990s showed a decrease (and lower incidence) tooth decay in schoolchildren living in areas where fluoridated water than in areas where water is not fluoridated.
The personal member bill to end fluoridation was defeated at DÃÆ'¡il on November 12, 2013. It was supported by Sinn FÃÆ'Â © in and some technical groups and was opposed by the Gael-Good Workers government and Fianna FÃÆ'¡il.
Recently there has been a lot of local opposition to the national fluoridation mandate. Beginning of 2014, the Cork County Council and the Laois County Council give a motion to stop the fluoridation of water. In Fall 2014, Cork City Council, Dublin City Council, and Kerry County Council passed similar moves.
Latvia
There is no water fluoridation in Latvia. The upper limit of Riga in natural fluoride is 1.5 mg/l.
Dutch
Air fluoride in most of the Netherlands from 1960 to 1973, when the Dutch High Council declared fluoridated drinking water illegal. The Dutch authorities have no legal basis for adding chemicals to drinking water if they do not contribute to a healthy water supply. Drinking water has not been fluoridated in any part of the Netherlands since 1973.
Norwegian
In 2000, representatives of the Norwegian National Institute for Public Health reported that no city in Norway is practicing water fluoridation. There was intense discussion about the problem around 1980, but no political discussions were taking place in 2000.
Serbian
About 300,000 people in Serbia (3%) received fluoridated water prior to 2003.
Spanish
About 10% of the population (4,250,000 people) receive fluoridated water.
Swedish
In 1952, NorrkÃÆ'¶ping in Sweden became one of the first cities in Europe to fluoridate its water supply. It was declared illegal by the Swedish Supreme Administrative Court in 1961, legalized again in 1962 and ultimately banned by parliament in 1971, after considerable debate. The parliamentary majority says there is a better way to reduce tooth decay than water fluoridation. Four cities received permission to fluidize tap water when legal. An official commission was formed, which published its final report in 1981. They recommended other ways to reduce tooth decay (improve food and mouth hygiene) than fluoridated tap water. They also found that many people find fluoridation to violate personal freedom/freedom of choice by forcing them to be treated, and that the long-term effects of fluoridation are not adequately recognized. Nor do they have a proper study of the effects of fluoridation on formula-fed infants. In 2004 the amount of fluoride allowed in water decreased to 1.5 mg/l.
Switzerland
In Switzerland, since 1962, two fluoridation programs have been operating together: water fluoridation in the City of Basel, and salt fluoridation throughout Switzerland (about 83% of domestic salts are sold plus fluoride). But the more difficult it is to separate the two programs. As a result, some Basel populations are assumed to use fluoride salts and fluoridated water. To remedy the situation, in April 2003, the Basel-Stadt Major Council decided to stop water fluoridation and expand salt fluoridation to Basel.
United Kingdom
About 10% of the UK population receives fluoridated water. About half a million people receive naturally fluoridated water with calcium fluoride, and about 6 million total receive fluoride water. The 2003 Water Law requires water suppliers to comply with requests from local health authorities to fluoridate their water.
The following British drinking water companies are fluidizing their supply:
- Anglian Water Services Ltd
- Northumbrian Water Ltd
- South Staffordshire Water plc
- Severn Trent plc
- United Utilities Water plc
Previous plans were made in the Health Authority of Bedfordshire, Hertfordshire, Birmingham, Black Country, Cheshire, Merseyside, County Durham, Tees Valley, Cumbria, Lancashire, North, East Yorkshire, North Lincolnshire, Northumberland, Tyne and Wear, Shropshire, Staffordshire, Trent West Midlands South where fluoridation was introduced progressively in the years between 1964 and 1988.
The Southern Center's Strategic Health Authority conducted its first public consultation under the Air Act 2003, and in 2009 its council voted for fluoridate water supplies in the Southampton area to cope with the high incidence of tooth decay in children there. Surveys have found that the majority of Southampton residents surveyed opposed the plan, but the Southampton City Primary Trust ruled that "public voices can not be a decisive factor and that medical evidence suggests fluoridation will reduce tooth decay - and fail to support claims of serious negative side effects ". The fluoridation plan has been highly controversial in northwest England and has been delayed after major increases in projected costs are revealed. In October 2014, the UK Public Health canceled plans for water fluoridation for 195,000 people in Southampton and neighboring southwest Hampshire due to good opposition from Hampshire County Council and Southampton City Council.
It was reported in 2007 that the UK Milk Fluoridation Program, centered in northwest England, involved more than 16,000 children.
Water supply in Northern Ireland has never been artificial fluoridation except in two small areas where fluoride is added to water for about 30 years. In 1999, fluoridation stopped in both areas, as well.
In 2004, following a public consultation, the Scottish parliament rejected a proposal to make fluoridation of public drinking water.
North America
Canada
The decision on whether to fluoridate lies with the local government, with guidelines set by provincial, regional and federal governments. Brantford, Ontario became the first city in Canada to fluoridate its water supply in 1945. In 1955, Toronto approved water fluoridation, but delayed program implementation until 1963 due to a campaign against fluoridation by broadcaster Gordon Sinclair. The city continues to fluoridate water today. In 2008 the recommended fluoride levels in Canada decreased from 0.8-1.0 mg/L to 0.7 mg/L to minimize the risk of dental fluorosis. Ontario, Alberta, and Manitoba have the highest fluoridation rates, around 70-75%. The lowest levels are in Quebec (about 6%), British Columbia (about 4%), and Newfoundland and Labrador (1.5%), with Nunavut and Yukon having no fluor at all. Overall, about 45% of the Canadian population has access to fluoride water supplies in 2007. The 2008 telephone survey found that about half of Canadian adults know about fluoridation, and from this, 62% support the idea.
In 2010, the Region of Waterloo held a non-binding referendum for residents to decide whether water fluoridation should continue. The voting result is 50.3% of the vote against fluoridation. The regional council honors the ballot, and over forty years of fluoridation in the city of Waterloo ends in November.
In 2011, the Calgary city council voted 10-3 to stop adding fluoride to city drinking water, after initiating water fluoridation in 1991. A research project was planned to study the impact of the Calgary termination, using Edmonton as a control.
On January 28, 2013, the Windsor city council voted 8-3 to stop the water fluoridation of Windsor water for five years, with respect to February 2012 recommendations by the Windsor Utilities Commission. Tecumseh gets its water from Windsor, and Tecmuseh's board has voted on March 13, 2012 to ask Windsor to stop fluoridation. Money previously spent on fluoridation is allocated to oral health and nutrition education programs. Air Windsor has been in fluoridation for over fifty years.
Lakeshore and Amherstberg have chosen to end water fluoridation.
Hamilton, London, and Toronto recently voted to continue fluoridation. Toronto treats the water to 0.6 mg/L.
Mexico
Mexico has no water fluoridation program; it has a table salt fluoridation program.
United States
In May 2000, 42 of the 50 largest US cities had water fluoridation. In 2010, 66% of all US residents and 74% of the US population with access to community water systems received fluoridated water. In 2010, a US Centers for Disease Control and Prevention Center determined that "40.7% of adolescents aged 12-15 years had dental fluorosis [in 1999-2004]". In response, the US Department of Health and Human Services along with the US Environmental Protection Agency proposed to reduce the recommended fluoride levels in drinking water to the lowest end of the current range, 0.7 milligrams per liter of water (mg/L), from the previous maximum recommendation 0.7-1.2 mg/L in recognition of increased fluoride sources such as fluoride toothpaste and mouthwash This can effectively stop urban water fluoridation in areas where fluoride levels from mineral deposits and industrial pollution exceed recommendations.
Oceania
Australia
Australia now provides fluoridated water for 70% or more of the population in all states and territories. Many Australian drinking water supplies started fluoridation in the 1960s and 1970s. In 1984 nearly 66% of Australians had access to fluoridated drinking water, represented by 850 cities and towns. Some areas of Australia have natural fluoride levels in groundwater, which were estimated in 1991 to provide drinking water to about 0.9% of the population.
The first city to provide fluoridation of water supplies in Australia was Beaconsfield, Tasmania in 1953. Queensland became the last country to formally require the addition of fluoride to public drinking water supply in December 2008.
New Zealand
The use of water fluoridation first began in New Zealand at Hastings in 1954. The Inquiry Commission was held in 1957 and then its use grew rapidly in the mid-1960s. New Zealand now has fluoridated water supplied to about half of the total population. Of the six major centers, only Christchurch and Tauranga do not have fluoridated water supplies. Wellington water supplies mostly contain fluoride, but the periphery of Petone and Korokoro receive non-fluoridated supplies. In Auckland, the suburbs of Onehunga and Huia Village do not make water fluoride. In 2013, an Austin City Council committee decided to eliminate fluoride from late June 2013. The referendum was held during the council elections in October 2013 with about 70% of voters voting for fluoride to be added back to the water supply, and by March 2014 the council voted 9 appeals 1 to reintroduce fluoride into the supply. In a 2007 referendum about half of voters in Central Otago, South Otago and the Southern Territories did not want fluoridation and voters in Waitaki District against water fluoridation for all Wards. Ashburton and Greymouth also voted against fluoridation. In 2014, the Chief Science Advisor of the Prime Minister and the Royal Society of New Zealand published a report on the health effects of water fluoridation.
South America
Brazil
In 2008, 41% of people (73.2 million) in Brazil received fluoride-made water.
Water fluoridation was first adopted in Brazil in the Baixo city of Guandu, ES, in 1953. The federal law of 1974 required the installation of new or enlarged water treatment to have fluoridation, and its availability was greatly expanded in the 1980s, with optimal fluoridation rates set at 0.8 mg/L. Currently, the expansion of fluoridation in Brazil is a government priority; Between 2005 and 2008, fluoridation was available to 7.6 million people in 503 municipalities. In 2008, 3,351 municipalities (60.6%) had adopted fluoridation, up from 2,466 in 2000.
Chile
In Chile, 70.5% of the population received fluoridated water (10.1 million were added by chemicals, 604,000 naturally). The Biobio region is the only administrative division that does not fluidize water.
References
Source of the article : Wikipedia
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