Water fluoridation in Massachusetts: a thirty-year review

By the end of 1997, only 121 communities (59 percent) of the population in Massachusetts were receiving fluoridated water serving 3,523,615 people. Eleven communities, three of which are naturally fluoridated, are partially fluoridated communities. According to the 1992 Fluoridation Census. Massachusetts was ranked 35th in the nation by percentage of its population living in fluoridated communities. From 1968 to 1997, there were 135 fluoridation orders by 112 communities, of which 67 (49.6 percent) had binding referenda, with 30 (45 percent) winning and 37 (55 percent) losing the vote (one community had one order and two referenda due to a court decision). Eventually, 78 (58 percent) of the 135 orders resulted in fluoridation being implemented. The average length of time from the order of fluoridation to its implementation was seven years, with a range of less than one year to 29 years. From 1968 to 1977, there were 91 fluoridation orders as compared to only eight from 1988 to 1997. Fluoridation is still the most cost-effective preventive measure for dental disease and needs to be promoted once again in Massachusetts.