The Goal
Water fluoridation's goal is to prevent tooth decay by adjusting the concentration of fluoride in public water supplies.[2] Tooth decay (dental caries) is one of the most prevalent chronic diseases worldwide, and greatly affects the quality of life of children, particularly those of low socioeconomic status.[16] In most industrialized countries, tooth decay affects 60–90% of schoolchildren and the vast majority of adults; although the problem appears to be less in Africa's developing countries, it is expected to increase in several countries there due to changing diet and inadequate fluoride exposure.[8] In the U.S., minorities and the poor both have higher rates of decayed and missing teeth,[21] and their children have less dental care.[22] The motivation for fluoridation of salt or water is similar to that of iodized salt for the prevention of mental retardation and goiter.[23] Use around the world Water fluoridation's science and practice are predominantly American.[75] It has been introduced to varying degrees in many countries outside the U.S., including Argentina, Australia, Brazil, Canada, Chile, Colombia, Hong Kong, Ireland, Israel, Korea, Malaysia, New Zealand, the Philippines, Singapore, Spain, the UK, and Vietnam. An estimated 12 million people in western Europe, 171 million in the U.S. (61.5% of U.S. population[76]), and 355 million worldwide (5.7% of world population[18]) receive artificially fluoridated water.[74] In addition, at least 50 million people worldwide drink water that is naturally fluoridated to optimal levels; the actual number is unknown and is likely to be much higher. Naturally fluoridated water is used in many countries, including Argentina, France, Gabon, Libya, Mexico, Senegal, Sri Lanka, Tanzania, the U.S., and Zimbabwe. In some locations, notably parts of Africa, China, and India, natural fluoridation exceeds recommended levels; in China an estimated 200 million people receive water fluoridated at or above recommended levels.[74] Locations have discontinued water fluoridation in some other countries, including Finland, Germany, Japan, the Netherlands, Sweden, and Switzerland.[18] This change was often motivated by political opposition to water fluoridation, but sometimes the need for water fluoridation was met by alternative strategies. The use of fluoride in its various forms is the foundation of tooth decay prevention throughout Europe; for example, France, Germany, and many other European countries use fluoridated salt.
