Environmental Protection Agency

The Environmental Protection Agency (EPA) regulates levels of fluoride in community drinking water. The EPA’s involvement in monitoring water quality dates back to 1974 with the enactment of the Safe Drinking Water Act (EPA, 2011a). The agency is required to determine safe levels of potential drinking water contaminants, or its maximum contaminant level goals. Fluoridation is not required by the EPA; in fact, it is prohibited by the Act from requiring the addition of any substance to drinking water for preventive health care purposes (EPA, 2011b). The decision to fluoridate a water supply is made by the state or local municipality. The CDC does provide recommendations about the optimal levels of fluoride in drinking water in order to prevent tooth decay.

In early 2011, the EPA released new fluoride risk and exposure assessments and announced its intent to review the national drinking water regulations for fluoride. The assessments addressed recommendations made by the National Research Council (NRC) of the National Academies of Science in a 2006 report titled, Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (NRC, 2006). The NRC’s report recommended that EPA update its risk assessment to include new data on the health risks of fluoride and better estimates of total fluoride exposure.

CURRENT REFORM EFFORTS

A Revitalized Oral Health Coordinating Committee (2009)

In 2009, newly appointed Assistant Secretary for Health Dr. Howard Koh asked the OHCC, located in the USPHS, to “regroup” (Bailey, 2010). Membership to the OHCC occurs through nomination by HHS operating divisions, staff divisions, or agencies with oral health functions. Other entities will also be included in the OHCC, such as national dental organizations and other federal agencies (e.g., DOD, VA, BOP, DOE) (Bailey, 2010).

Overall, the purpose of the OHCC is to “assist the USPHS in meeting its responsibility to promote the oral health of the American public: through coordination of a broad spectrum of oral health policy, research, and programs; within the USPHS; across federal agencies; and between public and private sectors” (Bailey, 2010). The specific functions of the OHCC are quite broad, especially given that the OHCC itself has not been allocated any funding and its membership all serve in full-time positions elsewhere in the department. The new charter enumerates 16 functions for the OHCC (Bailey, 2010):

1.   Provide policy direction for the USPHS through preparation, review, and evaluation of relevant USPHS and agency documents,



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