Jesica Bowman Chemistry 1010-0042 Professor Terry Roylance November 05, 2013 Fluoride and Water Fluoridation Fluoride

is a common drug used in today's society. In this paper I will discuss what fluoride is, how we came to use it the way we use it today, and water fluoridation. Fluorides effectiveness and uses for it have been studied since the early 19th century. Fluoride can be found in tooth paste, milk, and the controversial water fluoridation. Fluoride is an inorganic anion of fluorine, as well as a week base. Fluoride ions are found in many minerals besides fluorine with only trace amounts of the element found in water. Besides helping fight tooth decay some believe that fluoride could be used to help treat osteoporosis (6). In 1850 scientist had established that fluoride could be found in teeth, bones and drinking water (1). In 1900 a hypothesis of fluoride being able to help reduce tooth decay was made. Development of fluoridation took place in three major periods of time 1901-1933 Colorado brown stain studies, 1933-1945 H.V Churchill study and H Trendly Deans research, and 1945 to current. From 1901-1933 the main focus was on the cause of Colorado brown stain. Frederick McKay and G.V Black spent 30 years studying the condition of Colorado Brown stain and had a huge part in developing the foundation of water fluoridation.

McKay was first introduced to the discoloration of teeth when he moved from the east coast to Colorado Springs to open his own practice in 1901. He was shocked by the Brown staining of the teeth and the amount of natives that had the permanent discoloration. He tried to find a reason through medical books and the natives. The natives blamed the discoloration of the teeth on eating too much pork, poor quality milk and calcium rich water. McKay research into the disease was not a priority to the dental association of the time until a survey was done by the Colorado Spring Dental Society that showed 90% of local born children had the brown stained teeth. G.V Black who previously sneered at McKays research joined him in the research shortly after the survey was done in 1909 (12). Black and McKay made two major discoveries in the 6 years that they worked together. The first was that the staining was caused from childhood tooth care, meaning that children where the main population at risk of developing the brown staining. The second major discovery they made was that the teeth with Colorado Brown Satin where more resistant to tooth decay. In 1931 H.V Churchill came upon an unexpected conclusion while he was researching the staining looking to see if aluminum had a connection to the stain and found fluoride was a common factor in all off his water samples (2). Another key contributor was H Trendley Dean 1931, Dean and some of his colleges started out their research studying the harm of fluoride (3). They believed that fluoride at 1mg/L could reduce the amount of cavities. In January on 1945 they put their hypothesis to the test; they conducted a controlled experiment in Michigan. They fluoridated the water and where able to come up with the conclusion that fluoride did help reduce cavities. Dean was not the first to do a study like this; studies were done in

Canada (1945-192), Netherlands (1954-1970), New Zealand 91954-1970 and in the United Kingdom (1955-1960). Dean's group published their results in 1950(4.) After Dean's publication in 1951fluoridation became a policy of the U.S Public Health Services, and in 1960 about 50 million people in the US where drinking fluoridated water (9). In 2010 Center for Disease Control and prevention did a survey and out of the population of 308,745,538 people 204,283,554 of those people where drinking fluoridated water (5). U.S Centers for Disease Control and Prevention consider fluoridation as one of the top 10 great public health accomplishments of the 20th century (7). There are three kinds of fluoride used for water fluoridation; sodium fluoride, fluosilicic acid and sodium fluorosilicate. Sodium fluoride was the first one used it is a solid powder that is easy to handle. Fluorosilicic acid made up of two hydrogen (H2) one silicon (Si) and six fluorine's (F6) is in a liquid form comes in various concentrations but not as easy to handle as sodium fluoride. The third one that is used is Sodium fluorosilicate made up of two sodiums (Na2), one silicon (Si) and six fluorine's (F6). (7) All of three where chosen due to low cost and safety. Fluoridation is a cheap and easy way to provide the drug to the human population at an average cost of 1.01 per person per year. A lethal dosage for most adults is 5 to 10 grams. In 1994 the ADA came up with a recommended dosage chart for the consumption of fluoride for infants to adult
Figure 1 : Source (13)

hood (see figure 1).The average concentration of fluoride found in treated water is .7 to 1.2 ppm not enough to harm the average person (8). Water fluoridation has become a controversial subject that has many people doubting its safety and questioning if the government has a right to put it in community water without consent from everyone in the community. First of many reason why some people disagree with fluoridation of water is that it the only chemical that we add to water for medical reason. The FDA classified fluoride in water as a drug back in 2000. When it was added for the sole reason to help fight tooth decay a disease not caused by anything in the water itself. Those who oppose water fluoridation follow up with the claim that it is low income families that suffer from more tooth decay even with fluoride in their water due inability to afford better dental care (11). Figure 2 shows a graph comparing the tooth decay of children 12 years old who consume fluoridated water and those who consume non-fluoridated water around the world.
Figure 2

Some say that adding fluoride to the water is unethical. They support this statement by saying, that the government should not be able to add the fluoride to the main water supply. Without everyone in the community signing a wavier saying it is okay. They also believe that by letting the voters decide we take the right away from those who are unable to vote due to age or immigration status. The topic of possible over dose has also become a worry of those who are on the edge or against water fluoridation. The amount of fluoride is controlled an average of .7 to 1.2 ppm, which as stated earlier is not enough to kill the average adult. With saying that there has been a case of fatal poisoning of an adult at 4g of sodium fluoride(10)but also a case of an adult surviving a dosage of 120g (7).
Dietary Flouride Supplement Schedule 1994

The main groups that are at a higher risk of a possible overdose are children and
Birth-6 months None .25mg/day ** .50 mg/day 1.0 mg/day None None .25 mg/day .50 mg day None None None None AGE < 0.3 ppm Approved by the American Denatl Association,American Academy of Pediatrics, American Academy of Pediatric Dentistry Fluoride ion level in drinking water (ppm) * 0.3-0.6 ppm > 0.6 ppm

those who consume

6 months- 3 years

more water in a day

3-6 years

than the average adult. Due to the

6-16 years

*1.0 part per miliom (ppm)= 1mg/L

**2.2 mg sodium flouride contains 1 mg fluoride ion

dosage being controlled a child would ingest the same amount as an adult which could be harmful to the child. Smaller children (infants) can consume an estimated amount between .61.2 ppm it they are bottle feed and .004 ppm if they are breast feed (11). People who spend a lot

of time in the sun or exercising are also at risk of overdose, due to them consuming more water in a day then the average person. Fluoride has been studied for years and has become a key drug in todays world. Dentist use it on kids teeth at every visit, we add it to our tooth paste, mouth washes and even our water. While some may not like all the ways it is used and believe that it is not safe for mankind to consume as much as we do in a day, fluoride is here to stay.

Bibliography
1. http://en.wikipedia.org/wiki/Water_fluoridation 2. Mullen J. History of Water Fluoridation http://dx.doi.org/10.1038%2Fsj.bdj.4812863 3. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Achievements in public health, 19001999: Fluoridation of drinking water to prevent dental caries. 4. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1997106/ 5. http://www.cdc.gov/fluoridation/statistics/2010stats.htm 6. http://www.webmd.com/vitamins-supplements/ingredientmono-1068fluoride.aspx?activeIngredientld=1068&activeIngredientName+FLUORIDE 7. http://www.en.wikipedia.org/wiki/fluoride 8. http://www.fluoridedebate.com/question21.html 9. http://scielosp.org/scielo.php?script+sci_arttext&pid+S0042-96862006000900020 10. www.ncbi.nlm.nih.gov/pubmed/4677934 11. http://www.fluoridealert.org/articles/50-reasons/ 12. http://nider.nih.gov/OralHealth/Topics/Fluoride/TheStoryofFluoridation.htm 13. http://www.ada.org/sections/newsAndEvents/pdfs/fluoridation_facts.pdf