title: Fluoridation at fifty: what have we learned?
abstract: The question posed by the title of this article encompasses more than just the law and science applied to fluoridation. A review of the history and present status of fluoridation policy development and implementation makes it quickly apparent that the lessons learned are applicable to a wide range of public health policy and that the public health community needs to be very concerned about the status and trends of legal precedent. Indeed, in the context of recent U. S. Supreme Court decisions, the need for a comprehensive and coordinated effort to educate the public, legislators, and jurists about the safety and efficacy of community water fluoridation is clear. Two fundamental issues are at the core of this article: (1) the use of science in formulating and defending public health policy, and (2) how to connect scientific fact with the legal process in connection with the actual circumstances regarding a community's health status. The opening section of this article presents an analysis of fluoridation's great success in preventing dental caries over the past 50 years, along with a discussion of current data scientifically demonstrating that fluoride is safe when properly utilized. A second section provides an overview of one state's legislative experience in mandating fluoridation and the political challenges encountered. A final section discusses the legal issues associated with fluoridation, including the bases of legal challenges to public laws mandating it.
authors.affiliation: National Association of Local Boards of Health, Washington, DC, USA.
authors.forename: Edwin
authors.initials: E
authors.lastname: Pratt
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Rawson
authors.forename: Mark
authors.initials: M
authors.lastname: Rubin
mesh_terms: D003731:Dental Caries / Q000517:prevention & control*; D005457:Fluoridation / Q000331:legislation & jurisprudence*; D006284:Health Plan Implementation; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D037141:Mandatory Programs / Q000331:legislation & jurisprudence*; D011635:Public Health Administration / Q000331:legislation & jurisprudence*; D011639:Public Opinion; D014481:United States; D014881:Water Supply / Q000331:legislation & jurisprudence*