Dental News - Proposed fluoride upper limit increase in water systems open for comment

Dental Tribune International

Fri. 10. August 2018

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CHICAGO, U.S.: In a new development regarding fluoride levels in community water supplies, the Department of Health and Human Services (DHHS) and the Centers for Disease Control and Prevention (CDC) are seeking public comment regarding any evidence-based concerns about the appropriateness of a proposed operational control range of 0.6–1.0 mg/L. Comments can be made until Oct. 11.

One comment so far stated “As an oral health professional working in public health, an American Water Works Association and Rural Water Association member, I can say with firsthand experience, the extraordinary differences I see between a patient that has access to fluoridated water and a patient that does not. The CDC recommended 0.7 ppm as an optimal level, with an operating range of 0.6–1.0 ppm, is a workable range for our water operators and engineers to adhere to.”

Within the new proposal, the CDC made specific mention that managers of adjusted water systems at state and local levels need the updated operational control range in order to ensure the maintenance of consistent monthly averages in fluoride concentration. It noted that this is to maximize the prevention of dental caries and minimize the possibility of dental fluorosis.

In 2015, the DHHS recommended a then newly calibrated ratio of fluoride to water of 0.7 mg/L (from 0.6 mg/L), something the American Dental Association supported. However, the change did not stipulate an operational control range. Consequently, after the recommendation was issued, several state water fluoridation and drinking water programs contacted the CDC to request development of revised operational control range guidance around the 0.7 mg/L target level.

In this new proposed revision of fluoride levels, the CDC cited a number of studies which were used as references, including “Monitoring fluoride: How closely do utilities match target versus actual levels?” and “Dental caries and dental fluorosis at varying water fluoride concentrations”.

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