Water systems serving about 30 percent of Americans are not giving them fluoridated water, six decades after fluoridation was started as a public health measure to prevent tooth decay, officials said on Thursday.
The U.S. Centers for Disease Control and Prevention hails the reduction in dental cavities due to adding fluoride to public water supplies as one of the top 10 public health achievements of the 20th century.
Most Americans get their water from municipal or regional community water systems. A new CDC report showed that as of 2006, 69 percent of people in the United States who get water from these systems received fluoridated water, up from 65 percent in 2000 and 62 percent in 1992.
That means that while 184 million Americans get fluoridated water from community water systems, 82 million do not.
"This is one of the dirty little secrets - that the whole nation has not yet embraced fluoridation of water, which has enormous public health benefits," Dr. Georges Benjamin, executive director of the American Public Health Association, said in a telephone interview.
Fluoridation of public water supplies was introduced in 1945 in Grand Rapids, Michigan.
"It's still an under-utilized, very effective public health measure," Dr. William Bailey of the CDC's Division of Oral Health, who led the report, said in a telephone interview.
Some major cities still do not fluoridate their water supplies, including: San Diego; Portland, Oregon; Honolulu, Hawaii; and Wichita, Kansas. San Diego has committed to begin fluoridating its water by May 2010.
In California, the most populous of the 50 U.S. states, only 27 percent of people served by community systems were getting fluoridated water as of 2006, the CDC said. Only Hawaii (8 percent) and New Jersey (23 percent) were lower.
Fluoridation has remained controversial among some people. In fact, some opponents in the 1950s denounced it as a communist plot, which was lampooned in director Stanley Kubrick's 1964 Cold War satire "Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb."
Current opponents argue the fluoride being added to water may cause a health problems such as weak bones and bone cancer, an assertion the CDC rejects.
Asked if there is any responsible evidence showing negative health effects due to fluoridated water, Bailey said, "No, not at the levels that we use in community water systems."
The CDC report showed other states with low percentages of people served by community systems getting fluoridated water included: Oregon (27 percent), Montana (31), Idaho (31), Wyoming (36), Louisiana (40) and New Hampshire (43). Fourteen states topped 90 percent. Washington D.C., was at 100 percent.
"Most people are complacent about the issue because they just naturally assume they live in a city that's fluoridated," Bailey said.
Fluoride is added to water - either in powder or liquid form - at water treatment plants, normally at levels of about one part per million, Bailey said.
Roughly 10 percent of Americans, mostly in rural areas, get water from wells, and this typically is not fluoridated. Also, many Americans drink bottled water that is not fluoridated.
The government's goal is for 75 percent of U.S. residents on community systems to be getting fluoridated water by 2010.
