Status of state and national water fluoridation programs - Seventy years of progress in preventing tooth decay

Community water fluoridation has been recognized as one of ten great public health achievements of the 20th century and as a major contributor to improved oral health for the American public. 2015 marks the 70th year of the operation of water fluoridation in the U.S., beginning with Grand Rapids, Michigan in 1945. The historical growth and status of water fluoridation on the state and national levels will be presented. The U.S. Public Health Service in April 2015 issued a final recommendation to change the recommended optimal amount of fluoride in drinking water from a level ranging from 0.7 to 1.2 mg/L based on ambient air temperature to a uniform amount of 0.7 mg/L. The U.S. Department of Health and Human Services (HHS) had issued the proposed recommendation in 2011, convening a Federal inter-departmental, inter-agency panel of scientists to review scientific evidence related to recommendations for fluoride concentrations in drinking water in the U. S. The process followed in finalizing the recommendation and the scientific basis supporting it will be reviewed. The optimal concentration of fluoride in drinking water is that concentration that provides the best balance of protection from dental caries while limiting the risk of dental fluorosis. Potential issues regarding implementation of the final recommendation will be presented, such as water system administration, communication with the public, and adjustments to state and local administrative rules, law, regulation, or ordinance.