You Ask, We Answer: Does water fluoridation present unusual safety concerns for water facility operators?

With the release of the ADA’s latest edition of “Fluoridation Facts,” readers can learn the answers to hundreds of frequently asked questions about community water fluoridation and the latest scientific research. “Fluoridation Facts” — the Association’s free resource on fluoridation that examines the mineral’s effectiveness, safety, practice and cost-effectiveness — works to assist policymakers and the general public in making informed decisions about fluoridation. The new edition contains more than 400 references and 10 new Q&A’s for a total of 69 questions answered over 114 pages.

In an ongoing series, the ADA News is delving into many questions explored in the book through conversations with experts about fluoridation information and misinformation — from overall effectiveness to whether ingesting fluoride impacts IQ, health and reproduction.

Beth Fisher, deputy executive director of the Kentucky Cabinet for Health and Family Services, discussed whether water fluoridation presents unusual safety concerns for water systems and facility operators — question No. 52 in “Fluoridation Facts.”

Ms. Fisher said that with proper monitoring, maintenance and training, water fluoridation is a completely safe and reliable process. Water facilities adjust the level of fluoride in water to improve the oral health of the community, she noted, and personnel are subject to several regulations designed to ensure safety. These include conforming to Occupational Safety and Health Administration requirements, which aim to enforce standards that ensure safe and healthful workplaces, and undergoing training on the management of the additives in water plants.

Modern equipment helps water facility personnel monitor and maintain the desired fluoride concentration, and that automatic monitoring technology can also help ensure the fluoride concentration of the water remains within the recommended range, according to the ADA’s "Fluoridation Facts" booklet. Ms. Fisher said water facility personnel, as part of safety procedures, receive extensive training on the management of the additives in water plants and that the equipment used is well maintained.

“The Kentucky Department for Public Health trains operators through community water fluoridation-specific training that goes beyond base licensure to ensure the safety of both operators and the public,” she said.

All water additives, regardless of where they are produced must meet safety standards established by the American Water Works Association and NSF International. The Occupational Safety and Hazard Administration requires that every substance introduced into a water system, including fluoride, come with a safety data sheet to outline standard precautions to help avoid accidents and injuries. Safety data sheets include instructions for the safe use and potential hazards associated with a particular material and typically are made available in the area where the material is stored. Adherence to safety data sheet guidelines for handling fluoride additives helps to ensure that the recommended level of fluoride in drinking water flows through the water system while maintaining water operator safety.

Fluoride additives present risks comparable to other water additives in common use at water facilities, such as quicklime, aluminum sulfate, sodium hydroxide and ferrous sulfate. In some cases, the fluoride additives are much less dangerous than many other additives, including chlorine gas commonly used in many water facilities.

“When handled according to established safety procedures and dosing guidelines, fluoride compounds can be managed safely by trained water system staff,” she said.

Ms. Fisher emphasized that public water facilities play a critical role in protecting and promoting the public’s health and safety.

“Community water fluoridation is a bedrock component of public health programs across Kentucky, helping promote improved oral health by strengthening tooth enamel and preventing cavities,” she said. “Public water facility operators play an important role in helping to improve oral health outcomes statewide.”

For more information on this free resource, visit ADA.org/FluoridationFacts.