Colorado Fluoride Programs

Background

The state health department fluoridation program manages all aspects of the Community Water Fluoridation, and the School Fluoride Varnish Programs.  

The community health professionals must be made aware by written communication of any decision regarding participation in any of these two programs.  It is usually this group who drives the initiative to add the scientifically proven public health benefit within their community.  With their acknowledgement, proper prescriptions or treatments can be recommended to that very same population. 

Community Water Fluoridation within the state of Colorado is not regulated or non-enforceable.  However, all US Environmental Protection Agency rules and regulations apply to the Community Water Fluoridation Program just as they normally would if not adjusting, or managing the natural fluoride levels found in all water sources.  Communities can volunteer into the program by Mayoral delegation, Council or Board Decision, or even by public vote.  Once a community volunteers to provide the great public health benefit that comes from having optimal levels of fluoride in their public water, the community agrees to participate fully in the Colorado Department of Public Health and Environment program. 

School Fluoride Mouth Rinse within the state of Colorado is also a non-regulated volunteer program.  A Colorado Department of Public Health and Environment physician reviews this program periodically.  School nurses, in collaboration with County public health nurses, etc., usually not only recommend to school officials but devise a plan to administer the program in the kindergarten through sixth grade (elementary) schools.  The school must meet certain qualifications in order for the Colorado Department of Public Health and Environment to assist in the purchase of the mouthrinses.  If the school falls outside of the qualifications, they are more than welcome to participate, knowing that they must procure the mouthrinse themselves in order to provide the public health benefit to children.

The fluoridation specialist works to promote, maintain, monitor, and ensure safe, effective operations of existing public water fluoridation systems and participating schools. The specialist also sets priorities to begin fluoridation in new community water systems, and to help with the selection of new fluoridation systems.

In 1908, a Colorado Springs dentist, Dr. Frederick McKay, first discovered fluoridation in the State of Colorado, and its role in preventing tooth decay.  He noticed slight brown staining of the teeth in his young patients who grew up in the vicinity of Colorado Springs. Through 20 years of research, Dr. McKay found that the optimal amount of fluoride helps protect the teeth from decay, without causing objectionable cosmetic staining. In 1945, the first national trials began to adjust the water fluoride level to the optimal level in community water supplies of 1 part per million.  Most fluoride ion efficacy studies performed included the use of silica forms of the ion to include the use of the acid form, appearing for the first time in 1949.  For the last 55 years, water fluoridation has been a proven public health measure shown to be safe, economical, and effective in protecting the teeth of the population from dental decay. Currently, about 75 percent of Colorado residents on public water systems drink water that is optimal in fluoride.

The Colorado Department of Public Health and Environment in 1978 invested federal money to pay a dental hygienist based out of Ridgeway, CO to promote and educate the elementary schools on the West slope about the SFMR Program.  Currently, no dental hygienist at the Department exists to continue the field-work of promotion, but the Oral Health Program Manager (a dental hygienist), in conjunction with the CO Fluoridation Specialist, engage qualified schools and educate through provided resource materials.

In Colorado, the Department of Public Health and Environment administers a fluoridation program to help prevent tooth decay. It has the responsibility for informing the public of the fluoride levels in community water systems throughout Colorado. It also promotes, and monitors new fluoridation systems. There are approximately 75 community water systems that adjust fluoride to the optimal levels in Colorado. The total population served by adjusted fluoride in Colorado is more than half and approximately 2,516,000 (dated 2000).

However, there are several metro areas where fluoride is deficient at least part of the year. There are a total of 51 community water systems of a 1,000 population or more that are deficient in fluoride. These fluoride-deficient water systems serve approximately 571,000 people.

Safe and effective disease prevention measures exist that everyone can adopt to improve oral health and prevent disease.  These measures include daily oral hygiene procedures and other lifestyle behaviors, community programs such as community water fluoridation and tobacco cessation programs, and provider-based interventions such as the placement of dental sealants and examinations for common oral and pharyngeal cancers.

There are profound and consequential oral health disparities within the population.   Disparities for various oral conditions may relate to income, age, gender, race, ethnicity, or medical status.