Experience in Maintaining Constant Fluoride Concentrations

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Abstract
Some 34 million Americans are served drinking water to which prescribed amounts of the fluoride ion are added to reduce tooth decay. If the procedure is to impart maximum caries-preventive benefit to the child population, fluoride concentrations must be maintained at a constant optimal level. Data for Grand Rapids, Michigan, for 1945-1954 show clearly that accurate fluoride feeding were achieved during this entire decade of operation. In some instances the fluoridation process may be a more difficult one, although it is never impossible. Experience in 2 selected cities (designated A and B) demonstrates that high standards of performance were not consistently maintained and fluoride concentrations fell short of the recommended optimum. Dental examinations will not reveal until some years after the start of fluoridation whether reductions in dental caries prevalence are less than they should have been. Periodic current determinations of fluoride content and immediate correction of observed deficiencies can prevent this eventuality. The engineer bears the major direct responsibility for surveillance of the controlled fluoridation procedure. While a somewhat less direct responsibility lies with the dentist, failure now of both dentist and engineer to exercise the necessary vigilance can only bring undeserved discredit to one of the principal health advances of our time.
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