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A Lesson from Hawaii

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Hawaii has the lowest rate of water fluoridation of any state in the country. Of all Hawaiians whose homes are connected to community water systems, only 10.8% receive water that is fluoridated to the optimal level. Through the years, proposals have been made to expand fluoridation in the state, but to no avail. So what are the consequences of Hawaii’s low fluoridation rate?

In 2010, the Hawaii State Health Department screened more than 9,100 schoolchildren and found that more than one out of four — 27 percent — had serious dental problems that required “urgent or acute dental treatment.” In both 2010 and 2011, the Pew report gave Hawaii an “F” grade for children’s dental health. Last year, Ray Tsuchiyama wrote this column for The Maui News:

… the No. 1 health issue throughout the State of Hawai’i is oral health. It’s not diabetes. Not gout. Not hypertension. It is oral health.

… Locally speaking, the Hawaii Dental Agency conducts dental screenings for public school students. In 2010, more than 9,108 public school students in grades K-12 statewide were screened for dental problems. Hawaii Dental Agency referrals for “urgent or acute dental treatment” were made for 2,477 students – or nearly 30%, a third of all students.

 

Most military bases have provided fluoridated water for decades, and this practice has demonstrated its value.  Tsuchiyama made this point:

In 2007, a proposed Hawaii Legislature bill (it failed) for a fluoridation pilot program … contained a passage on the emphatic linkage between fluoride and dental health:

 

There is a dramatic documented variance in Hawaii between children attending military base schools whose water is fluoridated and children in non-military base schools. While many factors affect dental health, the fact that Hawaii’s military base water systems are optimally fluoridated is considered the major factor contributing to the superior oral health found among military base elementary school children.

… Having lived at Schofield military base as a child, I can attest that child consumption of candy and soft drinks at Schofield was equivalent to the off-base community (unfortunately). Nor were there dentists standing on every street corner to treat children. Nor was there a significant military base campaign on oral health. The point is that fluoride was the only “other” factor on Hawaii military bases that led to a fantastic low number: 1.5 decayed baby teeth per child.

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