Use of a compliance index for community fluoridation

Fluoridation of public water supplies is the best method of preventing dental caries. Yet, many water systems do not maintain the optimal concentration of fluoride. The Community Fluoridation Compliance Index was developed to provide retrospective and prospective information on water systems in complying with local and State standards. This index permits flexibility in the amounts of optimal fluoride concentration and the frequency of fluoride sample testing. In addition, the index can be modified to address the size of the population served by the water system. The index's components are reviewed, and its use is demonstrated on 50 water systems from Illinois and 50 from Ohio. Annual data from these two States show how this information can be used for targeting corrective action so that the population receives the greatest benefit from fluoridation. These findings suggest that the Community Fluoridation Compliance Index can be a useful administrative instrument for comparing relative compliance results. Further studies to determine its acceptance at the State and local levels are warranted.