FINDING THE OPTIMUM - FLUORIDATION OF POTABLE WATER IN SOUTH-AFRICA

Since the South African Department of Health had tabled legislation to make fluoridation of public water supplies mandatory the issue of whe ther fluoride is beneficial or harmful has, once again, become controv ersial in South Africa. We reviewed the literature, the experiences of fluoridation in overseas countries and the latest WHO recommendations , and have found that fluoride is desirable at certain levels, and und esirable above these. The following recommendations are made for optim um fluoride levels in South Africa's potable water: The decision to fl uoridate a public water supply must be a community decision taken afte r public consultation. However, it can only be reached when the public is properly informed about the issue. Optimum levels of fluoride for human health range from 0.4 to 0.7 mg F/l, depending on the maximum me an annual temperature. The maximum level of 0.7 mg F/l should not be e xceeded. Accordingly, it is recommended that in areas where natural fl uoride concentrations in the drinking water exceed 0.7 mg F/l steps be taken to defluoridate the water. As an interim measure, a scale of te mperature-adjusted optimum fluoride levels should be adopted in South Africa, rather than a single level covering the wide-ranging ambient t emperatures (and corresponding consumption rates of drinking water) in the country. A sliding scale would mean that the community within a w ater supply region can determine its own fluoride consumption within t he optimum range. Fluoridation should be considered only a short-term measure, until economic conditions are such that all South Africans ha ve access to proper dental health care. The duration of fluoridation o f a community water supply, and the level of fluoridation (within the optimum range of fluoride levels) should both be considered a communit y decision. However, defluoridation should be a permanent necessity in those areas where the drinking water exceeds levels of 0.7 mg F/l.