Abstract

Community water fluoridation (CWF) is the most effective and equitable approach to preventing dental caries (tooth decay). Yet millions of Americans, especially those at highest risk of caries, do not know what CWF is or its preventive benefits. State health departments are responsible for educating their respective populations. Thus, this study assessed health department websites (N = 50) to determine if CWF content existed, the ease of finding it, and if it was written in plain language and for a consumer audience. We used the web component of the HLE2: The Health Literacy Environment of Hospitals and Health Centers (HLE2) to assess how easy or difficult it was to the navigate a website and find information. Forty-one websites had CWF information; 37 states had content written for a consumer audience. HLE2 scores ranged from 0 to 54 points (60 possible). Only five states had websites with a HLE2 score of 50 or higher. SHDs with higher HLE2 scores were easy to navigate and their content was written for a consumer audience. Study findings suggest most SHDs should improve their website’s CWF content and its accessibility to better promote the role of fluoridated water in preventing dental caries.

Highlights

  • Over 75 years of scientific research has proven that optimally fluoridated water is the most cost-effective, safe and equitable way to prevent dental caries [1,2,3,4,5,6]

  • Thirty-one states had a link for Community water fluoridation (CWF) on the oral/dental health (ODH) homepage

  • Plain language is critical because the National Assessment of Adult Literacy (NAAL) found only 12% of adults have proficient health literacy [46], meaning only a small percentage of U.S adults understand health information well enough to take steps to promote health and prevent diseases such as dental caries

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Summary

Introduction

Over 75 years of scientific research has proven that optimally fluoridated water is the most cost-effective, safe and equitable way to prevent dental caries [1,2,3,4,5,6]. Community water fluoridation (CWF) helps reduce health disparities [7]. The U.S Centers for Disease Control and Prevention (CDC) named CWF one of 10 great public health achievements of the 20th century, and the agency continues to recommend this public health practice [9]. Recent studies show that dental caries (tooth decay) and the associated treatment costs increased significantly after communities discontinued water fluoridation [10,11,12].

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