Vermont Department of Health - Oral Health and 1 more... less...
Fluoride Treatment
# of natural fluoride in well water tests processed by the Vermont Department of Health Laboratory
Current Value
43
Definition
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Story Behind the Curve
Last Updated: March 21, 2023
Author: Office of Oral Health, Vermont Department of Health
Fluoride is present in virtually all water at some level. Health care providers should know the amount of naturally occurring fluoride in a child’s water source before prescribing supplements. About 28% of Vermonters receive their drinking water from a private water source. Unlike our public drinking water systems, private wells do not have experts regularly testing the water’s source and its quality before it reaches one’s tap (EPA, 2022).
At the optimal level of 0.70 parts per million, fluoride is a safe and effective way to prevent tooth decay in adults and children (ADA, 2021). Some wells naturally have an optimal level of fluoride, while some geographic areas around Vermont have private well or spring water that is above or below the recommended level for optimum oral health. It is important that prescriptions are not written for children who may already be receiving high levels of naturally fluoridated water. The only way to know for sure is to test the water for its level of natural fluoride before prescriptions for supplements are written.
The Vermont Department of Health Laboratory (VDHL) will test private wells or springs for fluoride for families with children 4 years of age and younger for free. Physicians and dentists provide the prepaid Lab test form to families to fill in the necessary information to be mailed or faxed to the VDHL. The families receive the kit, test their water, and return it to the Vermont Department of Health Laboratory for analysis. Parents and caregivers should speak with their pediatrician or dentist to review the fluoride testing results and other sources of fluoride ingested to help determine if fluoride supplements are recommended.
The curve represents a possible correlation between the number of well water tests processed and families with children under the age of four accessing health care. During these appointments fluoride supplementation and well water testing is discussed with the parent or caregiver.
Providers have noted a decline in appointments during the months of May and June and an increase in early August before the school year begins. This appears to be related with seasonal changes and possibly birth rates.
In the years following and during the COVID-19 pandemic 2020-2022 we have seen a decline in well water tests. This may be because during the pandemic the lab prioritized COVID-19 tests. Another factor may be staff turnover at medical and dental health care practices. The employees that left may not have trained the new employees about the well water testing form. Vermont’s Guide to Fluoride Levels in Public Water Systems has been updated and sent out; hopefully this will lead to an increase in participation.
What Works
Fluoride is a naturally occurring mineral, which helps to prevent cavities in children and adults. Testing fluoride levels in private water sources prior to prescribing fluoride supplements ensures appropriate supplementation for maximum benefit. Increasing patient and provider knowledge regarding the importance of correct fluoride supplementation and availability of the free fluoride in well water testing program can help turn the curve.
Action Plan
The Vermont Department of Health (VDH) encourages primary care providers to identify children at risk for Early Childhood Caries (ECC) and to help ensure that those children have access to early preventive care. The key preventive measure for ECC is the proper use of systemic fluoride: community water fluoridation or fluoride supplementation.
Vermont’s Guide to Fluoride Levels in Public Water Systems is a resource guide for primary health care providers (pediatricians, family physicians, physician assistants, nurse practitioners, etc.) and dentists to determine the level of fluoride in public community water systems. It contains information about the Free Fluoride in Well Water Testing Program and includes the Fluoride in Well Water Order Form for families to test their private well or spring water prior to prescribing supplementation. In 2024, an updated version will be printed and distributed to healthcare providers.
Community outreach to dental professionals has been successful in promoting the well water testing program because it is understood that before writing a prescription for fluoride your drinking water should be tested.
Public Health Dental Hygienists (PHDH) in the Women, Infant and Children (WIC) District Office clinics are encouraging parents and caregivers to test their well water for fluoride before receiving a fluoride supplement from their healthcare provider.
Notes on Methodology
This measure illustrates the number of private wells that have been tested for fluoride by families throughout Vermont by the Vermont Department of Health Laboratory.
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