Strengthening Community Water Fluoridation to Prevent Cavities

Cavities (tooth decay) are one of the most common chronic diseases among American children and adolescents. In 1945, Grand Rapids, Michigan made history as the first U.S. city to combat cavities by fluoridating its public water supplies. Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping the tooth surface strong, fluoride stops cavities from forming. Even before the 15-year study was complete, the results were clear: Compared to children born before the study started, those who were born after had 60% fewer cavities.

Jurisdictions across the country followed Grand Rapids’ lead, and now almost three-quarters of U.S. residents on public water systems benefit from fluoridated water.

According to the Centers for Disease Control and Prevention (CDC), children living in communities with fluoridated water have about 25% fewer cavities than children in communities without fluoridation. With rising health care costs, community water fluoridation is a cost-effective intervention to prevent oral health complications for people of all backgrounds, regardless of age, education, or income levels.

In partnership with the CDC, NACCHO began supporting local organizations in their community water fluoridation initiatives in January 2017. The pilot program offered funding and technical assistance to local communities to support either the replacement of aging water fluoridation equipment or the installation of new equipment.

The six grantees from the pilot, “Building Capacity for Oral Health: Fluoridation Equipment in Local Communities” completed their projects in June 2017.

“Our previous system would have to be taken offline several times a quarter due to maintenance issues, but since the new system we have not had to shut it down once. We are helping the community by now providing a constant and correct dosage of fluoride for dental health.” – Pilot Grantee

New water fluoridation equipment in the City of Fircrest, Washington

Five of the six original grantees said the program was “very impactful” in their ability to maintain their water fluoridation systems, noting that replacing old equipment and adding extra equipment for backup has ensured constant and reliable fluoridation for the community.

All grantees said the program was impactful in their promotion of water fluoridation benefits to the public. Increasing community comprehension of these benefits was an integral component of the pilot program.

“Our equipment was very old and not in good working order. The purchase of the new equipment provided much needed improvements to maintain our fluoride residuals and improve space in our well houses.” – Pilot Grantee

Given the success of the pilot program, the CDC funded a second cohort, and NACCHO awarded 17 new grants in December 2017:

  • City of Burnsville, MN: $40,000 (pop. served 61,000)
  • Oldham County Water District, KY: $40,000 (pop. served 11,500)
  • Town of Forest City, NC: $40,000 (pop. served 16,600)
  • Glacial Lakes Sanitary Sewer and Water District, MN: $38,279.73 (pop. served 3,839)
  • City of Parsons, KS: $35,000 (pop. served 10,500)
  • City of West Liberty, KY: $27,775 (pop. served 3,500)
  • Auburn Water District, City of Lewiston Water Division, ME: $26,600 (pop. served 51,765)
  • City of South Bend, WA: $25,000 (pop. served 10,500)
  • City of Barre, VT: $21,200 (pop. served 14,000)
  • Morehead Utility Plant Board, KY: $14,740 (pop. served 33,095)
  • Sterling Water and Sewer, KY: $14,676 (pop. served 16,298)
  • Bellows Falls Water Department, VT: $14,170.85 (pop. served 5,000)
  • Jefferson Parish, LA: $12,800 (pop. served 150,000)
  • Town of Cathlamet, WA: $6,600 (pop. served 2,500)
  • City of LaSalle, MN: $4,100 (pop. served 85)
  • West Virginia Oral Health Coalition, WV: $2,585 (pop. served 5,695)
  • City of Fairbury, IL: $1,712.95 (pop. served 3,900)

As part of their applications, the awardees submitted letters of support from partners expressing encouragement for the installation or continuation of community water fluoridation:

“The Minnesota Department of Health Oral Health Program strongly supports the Centers for Disease Control and Prevention in their recognition of community water fluoridation as one of 10 great public health achievements of the 20th century…We commend the City of Burnsville for its commitment to maintain this important evidence-based community investment which benefits both children and adults.” – Prasida Khanal, State Oral Health Program Director, Minnesota Department of Health

“Improvements to oral health in our village will have a significant impact on those who have the greatest need.” – Charles H. Wise Jr., Town Health Officer, Bellows Falls, VT

“According to the county health rankings for 2015, the ratio of dentists to the population for the county is 1:2,973. This is double what the ratio is for the state (1:1,453), thus creating an access issue for dental care for our citizens. Prevention is the key!” – MaLinda Hillman, Administrator, Livingston County Public Health Department

The 17 new grantees are currently installing new or replacing aging fluoridation equipment with all projects scheduled to be completed by June 30, 2018.

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