The lack of fluoride in community water sources may be detrimental to overall dental health of the county's residents, according to concerns from Pottawatomie County healthcare professionals.

Fluoride is a naturally occurring mineral that prevents tooth decay, according to the Centers for Disease Control and Prevention. While largely preventable, cavities are the most common chronic disease of children ages 6 to 19 years. Water fluoridation has been shown to reduce dental decay in children's teeth by 18 to 40 percent, according to the CDC.

None of Pottawatomie County's community water supplies have fluoride added to them. Most, such as the Shawnee Municipal Authority, have naturally occurring fluoride, but their concentration does not meet the CDC standard for the prevention of tooth decay.

The CDC recommends between 0.7 and 1.2 ppm of fluoride in the water to have a significant impact on the reduction of dental decay.

Shawnee's water supply, which serves about 31,000 residents, has the highest concentration of naturally occurring fluoride in the county at 0.4 parts per million, according to the Department of Environmental Quality.

The Tecumseh Utility Authority serves about 6,000 residents and has a fluoride concentration of 0.38 ppm, which is higher than most supplies, but still doesn't meet what the CDC recommends.

Shawnee stopped fluoridating its water in 2005 after Hurricane Katrina impacted the city's fluoride supplier, Shawnee City Manager Brian McDougal said.

Shawnee never resumed water fluoridation and no longer has the capability to do so, he said. Resuming fluoridation would require the city to build a new facility and system, which could cost between $150,000 and $200,000.

The Shawnee Pediatric Association and Shawnee Dental Association have approached McDougal about starting to add fluoride to the water again, he said, but Shawnee requires "additional capital needs" for water treatment and distribution.

Dr. Nan Shadid, who has been a dentist in Shawnee for 28 years, said she has noticed a significant increase in the number of children with cavities since Shawnee ceased water fluoridation.

"There's two ways to get fluoride in your system," Shadid said. "One way is topical using mouthwashes or toothpaste. The other way is systemic where it gets in through your bloodstream."

Only using fluoridated toothpaste or mouthwash is not sufficient to fight the amount of tooth decay seen in patients today, especially in infants, Shadid said.

"The only way babies are going to get enough fluoride to help them develop healthy teeth is by drinking fluoridated water," Shadid said.

Infants need to ingest the fluoride to help develop healthy teeth, she said.

Shadid said the problem with dental decay is so severe that she suggests patients use home water coolers and have fluoridated water delivered.

"I have a sign hung up in my office saying the water here (in Shawnee) isn't fluoridated," Shadid said. "Drinking fluoridated water and brushing with fluoridated toothpaste is the best way to combat decay."

Jeremy Holter, internist and pediatrician at the Saint Anthony Medical Clinic in Shawnee, said better oral health leads to better heart health.

"Adding fluoride to water can help reduce plaque buildup in the heart," he said. "Longevity correlates with dental health as well. Studies have shown that people who consume fluoridated water live longer than those who don't."

Holter said he's encouraged the city of Shawnee to resume fluoridating its water, but understands that cost is going to be a challenge.