Dental Cavities in Preschoolers – Blame the Parents, or Use Fluoride?

Today’s Managing Health Care Costs Indicator is 70%

It’s hard not to connect these two New York Times  headlines: 
  1.        Preschoolers in Surgery for a Mouthful of Cavities (March 7)
  2.        In New Jersey, a Battle over Fluoride and the Facts (March 2)

Yesterday's article notes a rise in preschoolers with severe dental cavities – as many as 12 teeth needing filling, root canals, and extraction.  The children often need general anesthesia for lengthy procedures – and continue to get cavities afterward.  The dentists quoted note that parents don't brush their kids’ teeth – and allow too much sickly sweet snack food. 

What the dentists don't note is that the answer to this problem is not likely more dental visits or demonizing neglectful parents.   The answer is fluoridation of public water supplies, which leads to a 50-70% decline in dental caries.   A bit over 72% of Americans currently get water from fluoridated municipal sources – although that figure is only 14% if New Jersey.   A move to bottled water can also deprive kids of the trace amounts of fluoride that help prevent cavities.  

There have been many concerns raised about potential ill effects of fluoride in the water supply.  Opponents decry government overreach, or suggest loss of IQ or discolored teeth.  Many municipal utilities don't want to take on the extra expense, especially in an environment with huge barriers to obtaining new revenue.  But fluoridation has been endorsed by five consecutive Surgeons General, and is recognized by the Centers for Disease Control as one of the ten most important public health advances of the 20th century.  

Small children with extensive dental decay is a big problem.  Let’s approach this from a public health perspective.  (We could save money, too.)