Oral Health Literacy and Fluoridation-Past, Present and Future

When Oral Health in America: A Report of the Surgeon General was published in 2000 few in dental public health had heard of, or were working in, the area of health literacy. This report clearly laid out the deficiencies of the public’s understanding about the best way to prevent dental caries (tooth decay). Specifically the report referenced, that two thirds of the NHIS respondents 25-65 years of age recognized the purpose of adding fluoride to water supplies was to prevent caries. Blacks and Hispanics were less likely than whites to know the purpose of this preventive procedure. More recent data suggest that these findings are similar among those with low levels of education and/or are Medicaid recipients. Health literacy is considered a determinant of health. Until recently, little focus has been given to increasing knowledge and understanding of the role of community water fluoridation in caries prevention by the public, health providers and policy makers in an organized, routine approach. Rather, the approach has been to try to educate the public or policy makers at the height of a fluoridation battle with mixed results. Recently PEW initiated widespread efforts to educate the public, providers and policy makers about the benefits of community water fluoridation. PEW’s effort is the most significant ever to be undertaken in the US and should be continued. Fostering continuous understanding of the dental health benefits of drinking community water with optimal levels of fluoride may be an important pathway to increasing and maintaining community water fluoridation.