Revista Brasileira de Odontologia Brazilian Journal of Dentistry Associação Brasileira de Odontologia - Seção Rio de Janeiro DOI: http://dx.doi.org/10.18363/rbo.v75.2018.e1124 1 Rev. Bras. Odontol. 2018;75:e1124 Original Article/Community Health Dentistry Access to fluoridated water: an overview since its implantation in a city of Rio de Janeiro State, Brazil Ana Paula Ferreira Marques, 1 Ariane Ferraz, 1 Lund Godinho Lima Netto, 2 Rafael Gomes Ditterich, 3 Flavia Maia Silveira, 1,2 Angela Scarparo, 2 Maria Isabel Bastos Valente, 1,2 Roberta Barcelos Pereira de Souza, 1,2 Andréa Videira Assaf 1,2 1 Posgraduate Program in Dentistry, School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil 2 Department of Specific Formation, School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, RJ, Brazil 3 Department of Community Health Dentistry, Paraná Federal University (UFPR), Curitiba, PR, Brazil • Conflicts of interest: none declared. AbstrAct Objective: to evaluate the fluoridation scenario in a city of the State of Rio de Janeiro, since its implantation to the present day. Material and Methods: water samples were collected from 2011 to 2017, in 21 locations of the city, analyzed by the electrometric method and classified based on the recommended national fluoride concentrations. Results: from a total of 2,297 samples collected, only 688 (29.95%) were within the recommended range (0.65-0.94 ppmF), with concentrations ranging from 0.00 to 1.92 ppmF and with an average concentration of 0.41 ppmF. During the period of evaluation, it was observed that the locations that were closest to the central region of the city were constantly fluoridated, and most of the samples were in accordance with the parameters recommended by CECOL-USP. On the other hand, in the peripheral neighborhoods, the samples were considered underfluoridated, which might result in inefficacy in the prevention of caries disease. Conclusion: the city showed a clear deficiency in maintaining of fluoride levels at adequate concentrations, which reinforces the relevance of controlling of this measure as part of a continuous surveillance action in oral health care. Keywords: Fluoridation; Water treatment; Public water supply. Introduction D ental caries is a chronic and multifactorial disease that afects a large part of the population of devel- oping countries, such as Brazil. Fluoride has the ability to reduce the incidence of caries and delay or reverse the progression of incipient lesions. 1 Fluoridation of public water supply was recognized in the 20th century, and the application of this measure has demonstrated good results in decreasing caries prevalence and incidence. 2 According to the Centers for Disease Report Control and Prevention, 3 fuoridation of public water supply is the safest, most efective and economical way to prevent caries, and it is also recommended by the American Dental Association (ADA), the International Association for Den- tal Research (IADR), and the World Health Organization (WHO). 4 Since May 24, 1974, by force of Law No. 6050, fuoridation of public water supply in Brazil is mandatory in locations with a Water Treatment Station (WTS). 5 Resolutions no. 635 and no. 2914, issued by the Ministry of Health in 1975 and 2011, respectively, set forth the regulations and standards for fuoridation and fuoride concentration - in parts per million (ppm) or milligrams per liter (mg/L), recommended for each location, and established the maximum amount of fuoride allowed in drinking water equal to 1.5 mg/L. 6,7 Despite the recognition of fuoridated water as an efec- tive, economical and comprehensive measure for dental car- ies prevention in places with a high prevalence of this dis- ease, 8 it is known that there are still cities in in Brazil that do not add fuoride to public water supply in spite of legal obli- gation. Te preventive efcacy of fuoride in drinking water depends on having an adequate fuoride concentration in the water consumed by the population and a continuity in the fuoridation process, making it essential to have control in terms of both operational procedures in the WTSs and sanitary surveillance as a basic right of citizenship in all cit- ies 5 . In some cases, there is budget limitation, but the costs of water fuoridations are much smaller than those related to the measures necessary to treat caries disease and its con- sequences. 8 Considering the lack of a structured oral health surveil- lance policy in many Brazilian cities, 9 as the city described in this study, reinforced by the proposal instituted by the National Oral Health Policy in 2004, the contribution of the universities is relevant in some surveillance actions, such as the control of fuoride levels in public water supply. 10 In this way, the purpose of the present study was to depict the scenario of public water supply fuoridation in the city of Nova Friburgo, Rio de Janeiro State, during a 84- month evaluation period (2011-2017), observing whether there were changes regarding the expansion and adequacy of fuorida- tion afer its implementation, in the year 2010. Material and Methods Characterization of the City and the Water Distribution Network Nova Friburgo is a city located in the mountainous region of Rio de Janeiro State, which has 185,102 inhabitants, 22,710 living in rural areas and 159,372 living in urban areas. It has