Fluoride

Introduction

Fluoride has both beneficial and detrimental effects on human health. In terms of dental health, the prevalence of dental caries is inversely related to the concentration of fluoride in drinking water; while there is a dose-response relationship between the concentration of fluoride in drinking water and the prevalence of dental fluorosis. In terms of general health, in communities where drinking water and foodstuffs are excessively high in fluoride, skeletal fluorosis and bone fracture are the most relevant adverse effects. However, there are also other sources of fluoride.

Processes such as desalination will remove virtually all fluoride from water. In terms of using such sources for drinking water, the implications for public health will strongly depend on local circumstances. However, the public health requirement is to maximise the beneficial effects of fluoride in drinking water supplies for caries prevention, whilst minimising the unwanted dental and potential general health effects.

The aetiology of dental caries involves the interplay on the tooth surface between certain oral bacteria and simple sugars (e.g. sucrose) derived from the diet. In the absence of those sugars in foods and drinks dental caries will not be a public health problem. However where sugar consumption is high or is increasing, dental caries will be or will become a major public health problem unless there is appropriate intervention.

Removing fluoride from a local drinking water supply by desalination could potentially exacerbate an existing or developing dental public health problem.