Reducing Tooth Decay--More Emphasis on Fluoridation Needed

HRD-79-3: Published: Apr 13, 1979. Publicly Released: Apr 13, 1979.

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A Federal research program on tooth decay prevention was started in 1971, but public officials cannot predict when the program will achieve a decrease in tooth decay. Tooth decay affects nearly every person in the United States and is a tremendous financial burden to the public and to the State and Federal Governments.

Questionable research expenditures have been made to develop prevention techniques that do not have widespread applicability and to demonstrate methods that were already successfully marketed, such as the $2 million spent to demonstrate school-based mouth rinsing. When these demonstrations were begun, this technique was already known to be effective and had been commercially marketed in 40 States. Relatively little is being done to promote fluoridation, a proven decay prevention technique. Greater emphasis is needed to promote this cost-effective technique for reducing tooth decay. The Safe Drinking Water Act has been misinterpreted in some communities as prohibiting fluoridation. Environmental Protection Agency regulations implementing the act are misleading in that fluoridation's dental health benefits are not prominently stated. The agency has agreed to amend the regulations.

Matters for Congressional Consideration

  1. Status: Closed - Not Implemented

    Comments: Congress has not acted on this recommendation and has indicated that it would not because of the political sensitivity of such action. However, The Environmental Protection Agency has changed its regulations to avoid any misinterpretation of the regulations and to conform with congressional intent.

    Matter: Congress should bring the Safe Drinking Water Act into closer conformance with the stated congressional intent and minimize its misinterpretation by amending section 1412b(6) to read "No national primary drinking water regulation may require or prohibit the addition of any substance for preventive health purposes unrelated to contamination of drinking water."

  2. Status: Closed - Implemented

    Comments: When we determine what steps the Congress has taken, we will provide updated information.

    Matter: Congress should consider establishing a program to provide financial assistance for communities that wish to fluoridate their water supplies.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: The agency does not agree with this recommendation and, therefore, plans to take no action. The criteria identified by GAO are developed individually for each contract demonstration project rather than set out as guidelines for all demonstration projects.

    Recommendation: The Secretary of Health, Education, and Welfare (HEW) should direct the Director of the National Institutes of Health to develop criteria for undertaking National Caries Program demonstration projects. The criteria should require an assessment of project objectives and the need to accomplish them, the adequacy of project design to provide scientifically valid data, the selection of sites, and the cost versus anticipated benefits.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of HEW should direct the Assistant Secretary for Health to increase efforts to educate the public about the decay preventive benefits of fluoridation.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of HEW should require the Assistant Secretary for Health to seek out organizations that can help educate the public about the benefits of fluoridation.

    Agency Affected: Department of Health and Human Services

  4. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of Housing and Urban Development should instruct regional officials to notify States and communities that the cost of fluoridation equipment may be included in title I water system improvement grants.

    Agency Affected: Department of Housing and Urban Development

  5. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of HEW should direct the Assistant Secretary for Health to determine whether the Public Health Service has now, or will have under section 317 of the Public Health Service Act, as amended, the authority to provide specific assistance to States, communities, and other authorities that want to fluoridate their water supplies and, if such authority is lacking, request that Congress provide it.

    Agency Affected: Department of Health and Human Services

  6. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of HEW should require the Assistant Secretary for Health to place greater emphasis on helping State and local public health agencies to promote fluoridation.

    Agency Affected: Department of Health and Human Services

  7. Status: Closed - Not Implemented

    Comments: The agency did not agree with the recommendation since the public benefits of the National Caries Program are reassessed at least annually by the Dental Caries Program Advisory Committee. In addition, workshops are held periodically to reassess the National Caries Program. Therefore, the agency does not plan to take any action.

    Recommendation: The Secretary of HEW should require the Director of the National Institutes of Health to periodically, but at least annually, reassess the potential public benefit of caries prevention techniques being funded by the National Caries Program.

    Agency Affected: Department of Health and Human Services

 

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