Oral

This session will provide up-to-date information on 1. The HHS recommendation to fluoridate community water supplies at 0.7 mg/L for all US communities, replacing the previous recommendation, since 1962, of a range from 0.7 to 1.2 mg/L according to average ambient air temperature. HHS cited two reasons for the change: increased sedentary lifestyle with reduced regional variability in water consumption; and increase in the prevalence and severity of dental fluorosis. 2. In January 2011, EPA announced plans to review the current national primary drinking water standard for fluoride, which establishes a maximum contaminant level (MCL) and maximum contaminant level goal (MCLG) for naturally occurring fluoride in drinking water of 4.0 mg/L to protect against crippling skeletal fluorosis. EPA is acting on a 2006 report from the National Research Council (NRC) recommending that severe dental fluorosis is not just a cosmetic effect of excessive fluoride intake during tooth development as previous reports had indicated, but is an adverse health effect due to increasing the risk for dental caries as a result of pitting of enamel in severe dental fluorosis. Following a recommendation from the NRC, the U.S. EPA conducted a dose-response assessment for severe dental fluorosis and updated the exposure assessment for fluoride from that supporting the 1986 MCLG/MCL of 4.0 mg/L. EPA released the dose response and exposure assessments in January 2011 when EPA announced its plans to review the drinking water standard.

Session Objectives: Attendees will be able to 1. Describe the rationale for supporting community water fluoridation 2. Identify key factors in recommending a standard 0.7 ppm fluoride concentration in drinking water for the U.S.A. 3. Identify key factors that EPA has to consider when evaluating whether it is appropriate to revise the MCLG/MCL for fluoride in drinking water for the U.S.A. 4. Describe the difference between fluoridation level and MCL. 5. Identify key messages to the public and stakeholders on this topic.