The Effect of Partial Defluoridation of a Water Supply on Dental Fluorosis—Results After 11 Years

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Abstract
For the past 11 years, excessive fluorides in the community water in Bartlett, Tex., have been chemically removed using activated alumina as the medium. During this period, the average level of fluoride delivered to water consumers has been 1.17 ppm. A base-line survey was conducted in 1954 using Dean''s Classification to determine the extent of dental fluorosis among the continuous resident children. A follow-up examination was made in the fall of 1963 after 11 1/2 years of partial defluoridation of the water supply. Children 10 years of age or younger in 1963 had a mean fluorosis score of 0.42, compared to the base-line figure of 2.36 for this age group. Children 11 years old and over, whose period of tooth calcification overlapped the change in fluoride content of the water supply, had a smaller reduction in average scores, which were 2.71 and 2.20 in 1954 and 1963, respectively. While 94% of children aged 10 or under examined in 1954 had positive signs of fluorosis, by 1963 only 21% exhibited mottling, and nearly all of these were the milder categories. No child 10 or under was seen in 1963 with severely mottled teeth and only 2 exhibited moderate fluorosis. Dental fluorosis is still a serious public health problem in many areas of the US. Persons living in nearly 400 communities consume water from public supplies containing more than twice the fluoride level considered as optimal. These communities, therefore, fail to meet the minimum requirements for public water supplies as established by the US Public Health Service.

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