Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health
1
Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul 03080, Korea
2
Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
3
Department of Dental Education, College of Dentistry, Yonsei University, Seoul 03722, Korea
*
Author to whom correspondence should be addressed.
Academic Editors: Marco Mascitti and Giuseppina Campisi
Int. J. Environ. Res. Public Health 2021, 18(5), 2372; https://doi.org/10.3390/ijerph18052372
Received: 27 January 2021 / Revised: 19 February 2021 / Accepted: 19 February 2021 / Published: 1 March 2021
(This article belongs to the Special Issue Dental Public Health: Issues, Challenges and Opportunities)
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.
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Keywords:
public dentistry; oral prevention; community water fluoridation; public health ethics; procedural justice
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Song, Y.; Kim, J. Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health. Int. J. Environ. Res. Public Health 2021, 18, 2372. https://doi.org/10.3390/ijerph18052372
AMA Style
Song Y, Kim J. Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health. International Journal of Environmental Research and Public Health. 2021; 18(5):2372. https://doi.org/10.3390/ijerph18052372
Chicago/Turabian StyleSong, Youngha; Kim, Junhewk. 2021. "Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health" Int. J. Environ. Res. Public Health 18, no. 5: 2372. https://doi.org/10.3390/ijerph18052372
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