In Water Crises, What are Dentists to Do?

In April 2014, a decision was made that would affect nearly 100,000 people. Due to changing resource needs, officials switched the water source of the City of Flint from the Detroit River to the Flint River. The Flint River plant was improperly processing the water, leading to high levels of lead, Legionella bacteria, and other contaminants in the municipal water supply. The US government was forced to declare a state of emergency, instructing Flint residents to use only bottled or specially filtered water for drinking, cooking, and even bathing.

So where did this leave dentists, who use water extensively with their drills, ultrasonic scalers and air/water syringes? Well, the Michigan Dental Association recommended and continues to advise that any practices that do not have "closed systems" (using distilled bottled water) to retrofit their operatories with these bottled units. The retrofits are not particularly expensive, but the hassle of installation and time required is a significant source of frustration for dentists who have been using city water for non-surgical procedures.

Another point of concern is the patients who no longer have access to fluoridated water. Detroit water has been fluoridated since the 1960s, and this fluoridation is often the only preventative oral health measure that low-income families have. Patients who do see a dentist regularly should be encouraged to accept fluoride varnish, rinse or supplements, and to brush with a fluoride-enhanced toothpaste. Any toothbrushes used before the lead content was discovered should be discarded.

The crisis in Flint illustrates how strongly the dental health of the public is tied to the water supply. In a serious water-quality crisis, rationing of bottled water leads to less overall water consumption and might lead to increased consumption of other beverages such as soda and sports drinks. Related to this, limited potable water may reduce brushing as a method of conservation. Drinking contaminated water anyway can increase inflammation and pose a serious health risk.

The example set by Flint is a sobering reminder that dental health will suffer as water scarcity increases – and it is increasing, not only in developing nations but in the United States as well. Over 80 percent of US aquifers have a groundwater footprint that is less than their area, and places such as California are beginning to see shortages as demand exceeds the replenishment rate.

Dengler, R. (2017). Study confirms how lead got into Flint’s water. PBS NewsHour. Retrieved 11 September 2017, from
Doctors explain the long-term health effects of Flint water crisis. (2017). Retrieved 11 September 2017, from
Michigan Dental Association. (2017). Flint Water Crisis. Retrieved 11 September 2017, from

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