Cover Sheet for Example Documentation

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1 Cover Sheet for Example Documentation Please complete the following form and submit along with your documentation. If you have any questions, please us at The following documentation has been submitted to ASTHO for the Accreditation Library as a potential example of Health Department documentation that might meet the PHAB Domain 10 Standard 2 Measure 4. This document is not intended to be a template, but is a reference as state health agencies develop and select accreditation documentation specific to the health department's activities. Please note that the inclusion of documentation in this library does not indicate official approval or acceptance by PHAB. Document Title: Document Date: Water Fluoridation Technical Training Program 2015 Version of Standards and Measures Used: 1.5 Related PHAB Standard and Measure Number Domain: 10 Standard: 2 Measure: 4 Required Documentation: Short description of how this document meets the Standard and Measure s requirements: 1 This is documentation of a statewide principles and practices workshop regarding Connecticut Water Fluoridation Technical Training Program. Documentation showed collaboration between water system operators and local health directors/staff regarding scientific evidence supporting fluoridation. Submitting Agency: Staff Contact Name: Staff Contact Position: Staff Contact Staff Contact Phone: Connecticut Department of Public Health Melissa Touma Accreditation Coordinator Melissa.touma@ct.gov

2 The Connecticut Department of Public Health Drinking Water Section & Office of Oral Health In Cooperation with the Metropolitan District Commission Presents 2015 Connecticut Water Fluoridation, Principles and Practices A Technical Training Program October 15, 2015 Training Center, Metropolitan District Commission The CT Department of Public Health Drinking Water Section (DWS) and Office of Oral Health (OOH) is presenting a free half-day training program on Water Fluoridation that will be of interest to Certified Treatment Operators, Chief Operators, and Local Health Officials/staff. Session will include: The Safety and Benefits of Water Fluoridation Fluoridation Regulatory Requirements Fluoridation from a Utility s Perspective Fluoridation: Lessons Learned Other Reasons to Attend: 4.0 training contact hours for the renewal of water treatment operator certifications An opportunity to learn about the safety and benefits of water fluoridation for the public An opportunity to network with your peers and with DWS staff during break times Registration: Limited to Certified Water Treatment Plant Operators and Local Health Department Officials/staff To register for the conference, please use the TRAIN website ( and follow the below listed instructions: Create account or login, SAVE THE DATE! 1. Under Keyword or Course ID enter then click the magnify glass symbol, 2. Under Title Click on 2015 Connecticut Water Fluoridation Principles & Practices, 3. Click on Registration tab 4. In the box provided type WTP if you are a CT Certified Treatment Plant Operator or LHD if you are a CT Local Health Official/staff person. 5. Click on Get Approval 6. A notice will appear that states Your request to take this course is being processed. You will receive an notification when an approval decision is made. 7. Upper right of screen Click on Log Off Please contact Bill Sullivan at (860) or William.sullivan@ct.gov for additional information. This event is funded by a grant from the Centers for Disease Control & Prevention.

3 Training Center, Metropolitan District Commission 125 Maxim Road Hartford, CT October 15, Connecticut Water Fluoridation, Principles and Practices 8:00 am to 8:25 am Registration 8:25 am to 8:35 am Introduction & Opening Remarks 8:35 am to 9:20 am Fluoridation of Public Drinking Water - One of the Top Ten Public Health Achievements Elizabeth Dowd RDH, LMSW, MPH Dental Services Coordinator CT DPH, Office, of Oral Health An overview of the safety and benefits of fluoridation 9:20 am to 9:55 am Regulatory Requirements for Fluoridation Carissa Madonna, Sanitary Engineer 2 CT DPH, Drinking Water Section Overview of regulations related to adding fluoride 9:55 am to 10:10 am Questions followed by a Morning Break 10:10 am to 11:10 am Exhibits Open Fluoridation from a Utility s Perspective Ray Baral, Certified Class IV Water Treatment Plant Operator Metropolitan District Commission Fluoridation A Utilities Perspective Operation & Systems 11:10 am to 11:45 pm Fundamental Concepts of Fluoridation Safety Chris Marcos President NPI Pump An overview of the safety aspects of adding fluoride to your water supply 11:45 pm to 12:30 pm Small Group Table Top Exercise - Q&A Period Evaluation Elizabeth Dowd, Carissa Madonna, Ray Baral, Chris Marcos CT DPH, MDC, NPI fielding questions 12:30 pm to 12:50 pm Networking and Exhibitor Browsing

4 Fluoridation of Public Drinking Water - One of the Top Ten Public Health Achievements Elizabeth A. Dowd RDH, LMSW, MPH. Dental Services Coordinator CT DPH Office of Oral Health Presentation slides Courtesy of CDC Water Fluoridation Principles and Practices & Matt Jacob Children s Dental Health Project 2015

5 Water Fluoridation Fluoridation Basics Historical Background Benefits Enamel Fluorosis Public Health Measure Status at 70 Fluoridation Science

6 Understanding the purpose of fluoridation: A disturbing trend in Americans health knowledge 62% 48% 48% Slide Source Mat Jacob--Children s Dental Health Project

7 Most Americans surf for health info 72% of Internet users say they searched online for health information within the previous year. 77% say they began their search with Google or Bing Slide Source Mat Jacob--Children s Dental Health Project

8 Slide Source Mat Jacob--Children s Dental Health Project

9 Navigating Fluoride Science

10 Facts vs. Myths Opponents of community water fluoridation have made claims that optimally fluoridated water can cause an array of health problems.

11 Myth: Fluoride Must be Bad- Look at the Label Almost anything can be harmful including calcium and Vitamin D if consumed in extraordinary amounts. Slide Source Matt Jacob--Children s Dental Health Project

12 Let s put this in context. Even many vitamin containers have warning labels. Slide Source Mat Jacob--Children s Dental Health Project (Source: Labeling information for NutraBio s Vitamin C supplement, sold in a 500-milligram dosage.)

13 Fact: There is no firm link to cancer. There is currently no firm evidence linking water fluoridation to cancer in general, or to specific cancers. Medical Research Council (U.K.) working group report: Water fluoridation and health The weight of the evidence indicates that fluoridation of water does not increase the risk of developing cancer. Agency for Toxic Substances and Disease Registry, U.S. Public Health Service Toxicological profile for fluorides, hydrogen fluoride, and fluorine (2003).

14 Osteosarcoma (Bone Cancer) Claims of association with fluoridation have existed for years Biologically plausible Very rare disease; difficult to study Scientists have conducted research NTP Studies I and II Harvard/National Cancer Institute Study Bassin et al (2006), Kim et al (2011) Expert panels have examined evidence Australia, NHMRC, (2007) National Research Council (2006) York Review (2000)

15 Immune System No association has been shown for immunological effects: There are animal studies, however studies use excessively high doses and inappropriate routes of administration No effect at levels used for CWF There is no evidence of any harmful effect on specific immunity following fluoridation nor any confirmed reports of allergic reactions. Challacombe SJ. Does fluoridation harm immune function? Comm Dent Health 1996;13(Suppl 2): National Research Council (1993)Health Effects of Ingested Fluoride

16 Myth: Fluoride lowers kids IQ scores Slide Source Matt Jacob--Children s Dental Health Project

17 Slide Source Matt Jacob--Children s Dental Health Project

18 Fluoride & IQ scores 2014 New Zealand study showed no link between fluoride and IQs. This study is more reliable because: It measured IQs over 30 years Community Water Fluoridation and Intelligence: Prospective Study in New Zealand It used a consistent IQ test It took many other factors into account, such as parents education Slide Source Matt Jacob--Children s Dental Health Project

19 Myth: Fluoride is Mass Medication Claim: Fluoridation is mass medication Fact: Fluoride is not a medicine - it is a nutrient which exists naturally in the environment. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press, 1999

20 Myth: Fluoridation is Wasteful Myth: Fluoride is wastefulonly for children Fact: Fluoridation is good for people of all ages 15% to 35% reduction in caries in adolescents and adults 27% reduction in adults (Griffin 2007) Older adults retaining more teeth than ever and have an improved quality of life.

21 Myth: Conspiracy Theory Claim: Water fluoridation is a vast conspiracy that grew out of a need to dispose of fluoride used to develop the atomic bomb Fact: This would require collusion on the part of researchers, universities, gov t agencies, private industry, federal, state and local governments.

22 Environmentally Safe

23 "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison." Paracelsus ( ) SALT

24 Myth: Fluoride Is No Longer Effective Fact: It is easy for people take oral health for granted Many of us have not known the ravages of tooth decay Must keep in mind the key role fluoridation plays - not only to oral health but to overall health

25 Water Fluoridation: Supported by Expert Consensus ew Children s Dental Campaign vailable at ttp:// rens-dental-policy WF: community water fluoridation

26 CDC named water fluoridation as one of 10 great public health achievements of the 20 th Century

27 Fluoridation Information Sources CDC web site at American Dental Association Fluoridation Facts available from American Association of Public Health Dentistry at Connecticut Department of Public Health: Drinking Water Section & Office of Oral Health at The Campaign for Dental Health at

28 Questions?

29 Contact Information Elizabeth A. Dowd RDH,LMSW,MPH phone (860)

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