Island Voices
Fluoride makes sense for Hawai'i

By Bruce Anderson
Director of the state Department of Health

According to the Centers for Disease Control and Prevention, approximately 88 million people (38 percent of the U.S. population) served by public drinking water do not have access to water with sufficient fluoride to prevent dental cavities. Children with lifelong exposure to optimally fluoridated water have at least 18 percent fewer cavities than children with no exposure to optimally fluoridated water.

Of all persons receiving optimally fluoridated community drinking water, approximately 85 percent are served by water systems for which the annual per capita cost of fluoridation is expected to be $1 to $1.25. The CDC estimates every $1 spent on water fluoridation could save as much as $80 in treatment costs for dental cavities in children.

Treatment costs for dental decay in young children can be substantial, especially if extensive dental procedures and general anesthesia in a hospital operating room are needed.

Because caries in the primary dentition disproportionately affect children from low-income households, the cost for care frequently is reimbursed by state Medicaid programs.

To determine whether the average treatment cost for Medicaid-eligible children in Louisiana differed by community fluoridation status, the Louisiana Department of Health and Hospitals and the CDC analyzed Medicaid dental reimbursements and Medicaid eligibility records from July 1995 through June 1996 for children aged 1 to 5 years. Findings suggest that Medicaid-eligible children in communities without fluoridated water were three times more likely than Medicaid-eligible children in communities with fluoridated water to receive dental treatment in a hospital, and the cost of dental treatment per eligible child was approximately twice as high.

This study in Louisiana is not the only study supporting community water fluoridation. Other recent reports have studied the cost benefits of community water fluoridation in Texas and New Zealand. Both studies agree that community water fluoridation is safe and is the most cost-effective way to prevent cavities for the entire community, regardless of socioeconomic status or access to available health care.

And although Hawai‘i is one of the healthiest states in the nation, currently Hawai‘i has one of the highest rates of tooth decay in the country.

[back to top]