Northeast Regional Health Officer

Because of its contribution to the large decline in cavities in the United States since the 1960s, CDC named community water fluoridation one of 10 great public health achievements of the 20th century. Unfortunately, residents of Sneedville are not currently benefiting from optimal fluoride levels in drinking water like most communities in Tennessee and the United States.

Fluoride is naturally present in all water sources, but the amount varies from place to place. During the first half of the last century, dentists noticed that children who lived in areas with higher levels of naturally occurring fluoride in their water had fewer cavities than children living in areas with lower levels of fluoride. This discovery eventually led to the recommendation by public health officials to adjust the natural fluoride content of drinking water in areas deficient in fluoride to optimal levels for the prevention of cavities (0.7 parts per million). Over time, the success of community water fluoridation in preventing cavities and tooth loss led to the development of fluoride-containing toothpaste and other products.

Fluoride acts in several ways to protect our teeth. Fluoride works to make the surface of the tooth resistant to the acid-forming bacteria that cause cavities. Fluoride also inhibits the ability of those bacteria to make the acid that damages teeth. This protects people of all age groups, not just children. Older adults can be particularly susceptible because receding gums leave the roots of teeth, which have no protective enamel, exposed to the bacteria and acid that cause cavities.

Some children who are at higher risk of cavities may benefit from additional sources of fluoride such as fluoride varnish or oral fluoride supplements. The American Dental Association recommends children age 6 months to 17 years at increased risk for developing cavities who live in communities with suboptimal water fluoride, such as Sneedville, be prescribed oral fluoride supplements by their primary care provider or dentist. However, most families have difficulty with ensuring their children take the fluoride supplements daily and it can be expensive over time. On the other hand, community water fluoridation is recommended by the American Dental Association, American Academy of Pediatrics, US Public Health Service and World Health Organization as safe and effective and is the most cost-effective way to deliver fluoride to people of all ages, education levels and income levels who live in a community.

For optimal dental health, the Tennessee Department of Health recommends children and adults drink water with optimal amounts of fluoride and brush their teeth twice a day with fluoride toothpaste.