A review on the ethics of artificial water fluoridation.

Artificial water fluoridation refers to the addition of fluoride compounds usually hexafluorosilicic acid to public drinking water supplies. It is a controversial public health intervention, the ethics of which have been debated since its inception in the 1950s. Dr. Trendley Dean, in 1931, found that there was an inverse relationship between the concentration of fluoride and the incidence of dental caries. It was concluded that a concentration of 1 parts per million (ppm) of fluoride in water offered significant protection against dental caries. On the other hand, higher concentrations than 1 ppm fluorides have adverse effect on the teeth. Dr. Frederick McKay who was the pioneer in this field, his research based in Colorado Springs, did extensive research as to the effect of fluoridated water and its role in staining and mottling of the enamel. This “Mottled enamel" is characterized by small white flecks or yellow-to-brown spots scattered over the surface of the tooth. Furthermore, fluoride at even higher concentrations leads to a number of complications including skeletal fluorosis and fluoride toxicity which can affect multiple organs. The ethical debate as to the artificial fluoridation of water still goes on. There is significant research proving its efficacy in combatting dental caries. However, the counter argument stating that in the light of the increasing evidence of harm fluoridation poses, artificial water fluoridation must be abandoned and replaced with other effective community-wide and targeted oral health intervention. [ABSTRACT FROM AUTHOR]