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Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health

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  • Youngha Song

    (Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul 03080, Korea
    Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia)

  • Junhewk Kim

    (Department of Dental Education, College of Dentistry, Yonsei University, Seoul 03722, Korea)

Abstract

Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of individual concern or social responsibility. As dental caries is a public health problem, public health ethics should be applied to the topic instead of generic clinical ethics. From both pro- and anti-fluoridationists’ perspectives, CWF is a public health policy requiring a significant level of intervention. Thus, there needs to take further considerations for justifying CWF beyond the simple aspect of utility. For further ethical considerations on CWF, three caveats were suggested: procedural justice, social contexts, and maintenance of trust. The process to justify CWF should also be justified, not simply by majority rule but participatory decision-making with transparency and pluralistic democracy. Social contexts are to be part of the process of resolving conflicting values in public health interventions. Public trust in the dental profession and the oral healthcare system should be maintained over the considerations. This article suggests accountability for reasonableness as a framework to consider infringement by CWF for public justification of its implementation.

Suggested Citation

  • Youngha Song & Junhewk Kim, 2021. "Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health," IJERPH, MDPI, vol. 18(5), pages 1-10, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2372-:d:508108
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    References listed on IDEAS

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    1. Katherine Ho & Matthew Neidell, 2009. "Equilibrium effects of public goods: The impact of community water fluoridation on dentists," NBER Working Papers 15056, National Bureau of Economic Research, Inc.
    2. Martin, Douglas K. & Giacomini, Mita & Singer, Peter A., 2002. "Fairness, accountability for reasonableness, and the views of priority setting decision-makers," Health Policy, Elsevier, vol. 61(3), pages 279-290, September.
    3. Broadbent, J.M. & Thomson, W.M. & Ramrakha, S. & Moffitt, T.E. & Zeng, J. & Page, L.A.F. & Poulton, R., 2015. "Community water fluoridation and intelligence: Prospective study in New Zealand," American Journal of Public Health, American Public Health Association, vol. 105(1), pages 72-76.
    4. Carstairs, C., 2015. "Debating water fluoridation before Dr. Strangelove," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 1559-1569.
    5. Viehbeck, S.M. & Petticrew, M. & Cummins, S., 2015. "Old myths, new myths: Challenging myths in public health," American Journal of Public Health, American Public Health Association, vol. 105(4), pages 665-669.
    6. Grandjean, P. & Choi, A.L., 2015. "Community water fluoridation and intelligence," American Journal of Public Health, American Public Health Association, vol. 105(4), pages 1-3.
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    Cited by:

    1. Man Hung & Amir Mohajeri & Jody Chiang & Jungweon Park & Beatrice Bautista & Chase Hardy & Martin S. Lipsky, 2023. "Community Water Fluoridation in Focus: A Comprehensive Look at Fluoridation Levels across America," IJERPH, MDPI, vol. 20(23), pages 1-11, November.

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