Endnotes

Welcome

  1. Empey GB, Bradley KJ. 2007. Oregon Smile Survey 2007. Portland, OR: Oregon Department of Human Services, Office of Family Health, p.12 & Scheer M. 2011. Smile Survey 2010. The Oral Health of Children in Clark County, Washington. Vancouver, WA: Clark County Health Department, p. 5. See also ttp://www.kingcounty.gov/healthservices/health/personal/OralHealth/~/media/health/publichealth/documents/oralhealth/2010SmileSurvey.ashx
  2. Achievements in Public Health 1900–1999—Fluoridation of Drinking Water to Prevent Dental Caries. MMWR, October 22, 1999;48 (41);933–940.
  3. Centers for Disease Control and Prevention. Ten great public health achievements—United States, 1900–1999. MMWR Morb Mortal Wkly Rep 1999 Apr 2;48(12):241-3.

The crisis

  1. Empey GB, Bradley KJ. 2007. Oregon smile survey 2007. Portland, OR: Oregon Department of Human Services, Office of Family Health, p.5
  2. Ibid.
  3. Ibid.
  4. United States Department of Health and Human Services. (2000). Oral health in America: A report of the Surgeon General. Rockville, MD: NIH. See also http://www.pewstates.org/uploadedFiles/PCS_Assets/2012/A%20Costly%20Dental%20Destination(1).pdf
  5. Center for Disease Control and Prevention. (2009). State Oral Health Profile.
  6. Center for Disease Control and Prevention. (2009). State Oral Health Profile.
  7. Center for Disease Control and Prevention. (2011). National Oral Health Surveillance System.

Why fluoride?

  1. Centers for Disease Control and Prevention. Ten great public health achievements—United States, 1900–1999. MMWR Morb Mortal Wkly Rep 1999 Apr 2;48(12):241-3
  2. American Dental Association. Statement on the Effectiveness of Community Water Fluoridation.
  3.  Based on the estimates provided to Upstream Public Health by the Water Bureau, it would cost $575,000 per year in annual costs (or less if different fluoride compounds are chosen).  The Water Bureau estimates there are 932,000 water users, so this amounts to $0.61 per person per year.
  4. A study conducted by the Delta Dental Plans Association found that the average cost to maintain a restored cavity in the molar of a 10-year old reaches $2,187 by the time he or she is 79. See also
    http://www.deltadentalins.com/about/community/cavity-cost.html
  5. Griffin, S., Jones, K., & Tomar, S. L. (2001). An economic evaluation of community water fluoridation. Journal of Public Health Dentistry. 61(2), 78-86. Studies commissioned by the Centers for Disease Control have estimated that fluoridation for larger cities saves on average $38 for every $1 invested in fluoridation, or $19 per person per year.  This amounts to over $20 million per year for the greater Portland area.  However, dental costs have increased considerably since the study was published, indicating that actual cost savings are likely much more.  Economic savings: Griffin, S., Jones, K., & Tomar, S. L. (2001). An economic evaluation of community water fluoridation. Journal of Public Health Dentistry. 61(2), 78-86. Increased costs: Aon Hewitt. (2011). 2011 Health Care Trend Survey.

Healthier Kids

  1. U.S. Department of Health and Human Services. (2000). Oral Health in America A report of the Surgeon General, executive summary. HHS, NIH, NIDCR, NIH publication 00-4713
  2. Center for Disease Control and Prevention. (2009). State Oral Health Profile.
  3. Center for Disease Control and Prevention. (2009). State Oral Health Profile.
  4. Center for Disease Control and Prevention. (2011). National Oral Health Surveillance System.
  5. Empey GB, Bradley KJ. 2007. Oregon smile survey 2007. Portland, OR: Oregon Department of Human Services, Office of Family Health, p.5
  6. A study conducted by the Delta Dental Plans Association found that the average cost to maintain a restored cavity in the molar of a 10-year old reaches $2,187 by the time he or she is 79. See also
  7. www.rwjf.org/content/rwjf/en/research-publications/find-rwjf-research/2009/04/the-costs-of-dental-care-and-the-impact-of-dental-insurance-cove.html
  8. Centers for Disease Control and Prevention. (2012). Preventing Dental Caries with Community Programs.

Healthier Schools

  1. S. Blumenshine et al. (2008). Children’s School Performance: Impact of General and Oral Health. Journal of Public Health Dentistry 68 82-87.
  2. Gift, H.C. (1997). Oral health outcomes research: Challenges and opportunities. In Measuring Health and Quality of Life, ed. G.D. Slade, 25-46. Chapel Hill, NC: Department of Dental Ecology, University of North Carolina.
  3. Pew Center on the State. See also Pourat,  N., Nicholson, G. (2009). Unaffordable Dental Care is Linked to Frequent School Absences. Los Angeles, CA; UCLA Center for Health Policy Research, 2009. Pp. 1-6.
  4. S. Blumenshine et al. (2008). Children’s School Performance: Impact of General and Oral Health. Journal of Public Health Dentistry 68: 82-87.
  5. US Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General– Executive Summary. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health.
  6. Chen, M., R. M. Anderson, D. E. Barnes, M. H. Leclerq and C.S. Lyttle. (1997). Comparing Oral Health Care Systems: A Second International Collaborative Study. Geneva, Switzerland: World Health Organization.

People of color

  1. U.S. Department of Health and Human Services, Office of Minority Health. Based on Healthy People 2010 baseline data.
  2. Ibid.
  3. Ibid.
  4. Ibid.
  5. Ibid.
  6. Ibid.
  7. Ibid.
  8. DeBiasi, A, Edelstein, B. (2005). Children’s Dental Health Project. CDHP Fact Sheet Native American Child Oral Health.
  9. The Pew Center on the States. (2010). The Cost of Delay: State Dental Policies Fail One in Five Children.

Low income

  1. Vargas, C., Crall, J., Schneider D. (1998). Sociodemographic distribution of pediatric dental caries. NHANES III. 1988- 1994. J Am Dental Association. 129:1229 – 1238
  2. US Department of Health and Human Services. (2000). Oral Health in America: A Report of the Surgeon General– Executive Summary. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health.
  3. http://www.deltadentalins.com/about/community/cavity-cost.html
  4. Eberhardt MS, Ingram DD, Makuc Dm, et. al. (2001). Urban and Rural Health Chartbook. Health, United States. Hyattsville, Maryland.
  5. Empey, GB, Bradley,  KJ. 2007. Oregon Smile Survey 2007. Portland, OR: Oregon Department of Human Services, Office of Family Health
  6. Ibid.

Dollars and sense

  1. http://healthpolicy.ucla.edu/publications/Documents/PDF/Unaffordable%20Dental%20Care%20Is%20Linked%20to%20Frequent%20School%20Absences.pdf
  2. Willis, M., Esqueda, C., Schact, R. (2008). Social Perceptions of Individuals Missing Upper Front Teeth. Perceptual and Motor Skills, Vol. 106. pp.423-435.
  3. Centers for Disease Control and Prevention (2006). Division of Oral Health, Oral Health for Adults.
  4. Ibid.
  5. Glied, S., Neidell, M. (2010). The Economic Value of Teeth. Journal of Human Resources. p. 3

Safe for the environment

  1. The change in the fluoride concentration of the Columbia River was calculated with the formula described in the paper Osterman, AJPH 1990. This formula uses a very conservative assumption that all the fluoride added to the water supply would end up in the river. The average value for the flow rate of the municipal water (101 mgd) was obtained from the Portland Water Bureau. The median flow rate of the Columbia (127,971 mgd) and the median fluoride concentration in the Columbia (0.12ppm) were obtained from the United States Geological Survey.  Data was collected at Warrendale, Oregon, slightly up river from Portland and before the Willamette River flow is added to the Columbia. This provides a conservative (i.e. lowest) estimate for the flow rate and fluoride concentration. The current fluoride concentration of the Bull Run water supply was assumed to be 0.1 ppm based on Water Bureau tests, and the optimal fluoridation rate was assumed to 0.7 ppm. Using this data and equation, the change in fluoride concentration in the Columbia due to fluoridation of the Bull Run water supply was estimated as 0.00047 ppm.
  2. Centers for Disease Control and Prevention. (2012). Community Water Fluoridation.
  3. NSF Fact Sheet on Fluoridation Chemicals. (2012). See also http://www.nsf.org/business/water_distribution/pdf/NSF_Fact_Sheet.pdf
  4. National Research Council. (1999). Subcommittee on Arsenic in Drinking Water. 3 Chemistry and Analysis of Arsenic Species in Water and Biological Materials. Arsenic in Drinking Water. Washington, DC: The National Academies Press. p. 50.