A lot has been made lately by some that the effect of fluoride on teeth appears to be mainly topical. They have used this to suggest that water fluoridation is an ineffective method of caries prevention. This conclusion demonstrates the lack of willingness, prevalent in most anti-fluoridationists, to truly understand the science involved. They latch onto the one piece of the story that suits their purpose while ignoring the complete picture.

Let me explain the complete picture. Some recent studies have suggested that the main effect that fluoride has on strengthening the enamel is through topical contact with the teeth once they have erupted into the mouth. One of the most recent studies was published in the Journal of the American Dental Association in July of this year by Dr. John D.B. Featherstone.

You need look no further than the abstract of that article to see how some have missed the real message. It states: "Fluoride in drinking water and in fluoride-containing products reduces caries via these topical mechanisms." As you read further in the article, it explains that as you drink water that is optimally fluoridated, it becomes present in the saliva in the optimal amounts and provides a constant, ongoing topical treatment of the teeth. It does this for everyone, all the time, regardless of age, race, gender, socioeconomic status or schedule. It provides this topical benefit to the public, and all the public has to do is go about their daily routine.

What needs to be understood is that whether fluoride works systemically or topically, it must be constantly present in low doses to be maximally effective. Fifty years of experience has shown the scientific world that when all other factors are taken into consideration, the most cost-effective way to do this and benefit the most people is by the safe and simple adjustment of natural fluoride levels in the drinking water.

Wayne W. Cottam DMD, MS

Salt Lake City