TABLE OF CONTENTS Thomas G.Reeves, P.E.
National Fluoridation Engineer
U.S. Public Health Service
Centers for Disease Control and Prevention
Atlanta, Georgia
Fluoridation of public water supplies has been practiced since 1945. Few public health measures have been accorded greater clinical and laboratory research, epidemiological study, clinical trials, and public attention than water fluoridation. This chapter will present an overview of the history of fluoridation, as well as the public health and engineering aspects.
Fluoridation is the deliberate adjustment of the fluoride concentration of a public water supply in accordance with scientific and medical guidelines. Fluoride, a natural trace element, is present in small but widely varying amounts in practically all soils, water supplies, plants, and animals, and is a normal constituent of all diets (Hodges and Smith, 1965). The highest concentrations in mammals are found in bones and teeth. Virtually all public water supplies in the United States contain at least trace amounts of fluoride from natural sources.
The study of the relationship between fluoride in drinking water and dental health has an interesting and intriguing history. The series of studies that led to a demonstration that fluoridated water had caries-inhibiting properties was one of the most extensive programs carried out in the epidemiology of chronic disease. It began in 1901, when a U.S. Public Health Service (USPHS) physician stationed in Naples, Italy wrote that black teeth observed in emigrants from a nearby region were popularly believed to have been caused by using water charged with volcanic fumes. It was later determined...
