Fluoride & Fluoridation

By: Matt Jacob

Community Water Fluoridation

Fluoride is a mineral that exists naturally in public water supplies, but usually at a concentration that is too low to protect teeth from cavities. This is why so many community water systems add additional fluoride — a process called “fluoridation.” Fluoridation reduces the rate of tooth decay by about 25 percent over a person’s lifetime. Both children and adults benefit from drinking fluoridated water.

For 70 years, community water fluoridation has been an effective and safe way to reduce the rate of tooth decay. Even in an era when fluoride toothpaste is widely used by Americans, studies in recent years continue to show that drinking water or other beverages with fluoride maximizes protection from cavities. The Centers for Disease Control and Prevention (CDC) supports fluoridation and named this practice one of its “10 great public health achievements of the 20th century.” Other leading health and medical organizations join the CDC in supporting fluoridation. U.S. Surgeon General Vivek H. Murthy issued this statement about fluoridation in April 2015, noting that "each generation born since the implementation of water fluoridation has enjoyed better dental health than the preceding generation."

A CDC-commissioned study found that every $1 invested in fluoridation saves $38 by reducing the need for dental fillings, crowns or other treatments. Studies in various states have confirmed that fluoridation saves money for families and taxpayers.

Opponents of fluoridation often make claims or assertions that misrepresent what the scientific evidence shows. The National Research Council has issued four reports on fluoride or fluoridation (including two since 1993), and none of them has voiced concerns about fluoride at the levels used for water fluoridation. In April 2015, the CDC issued this statement about fluoridation's safety and effectiveness.

The Children's Dental Health Project (CDHP) develops and delivers training for dental and medical practitioners, children's advocates or others who want to be more effective spokespersons in support of fluoridation. Contact Matt Jacob at mjacob@cdhp.org if you are interested in learning more.


This tool-kit, produced to observe 70 years of fluoridation in the U.S., provides resources to health professionals, parents and other people who wish to advocate for community water fluoridation in their states or communities.

Few health topics have been studied as thoroughly as fluoride and fluoridation. This Q&A by the Children’s Dental Health Project provides answers to questions that frequently arise, drawing on the research that has been done.

Who decides within a community whether the local water system will be fluoridated? What legal authority do states, cities or counties have? These and other questions are answered in a Q&A produced by the Children’s Dental Health Project.

This one-pager provides brief statements from four governmental, medical or dental organizations that have examined the research behind fluoridation, its safety and its benefits. Public health advocates can use this as a handout for policymakers or stakeholder groups.

  • Fluoridation: How States Rank

By the end of 2012, nearly 211 million Americans had access to drinking water that was fluoridated to help prevent tooth decay. This CDC web page shows how well the 50 states and District of Columbia are doing to make fluoridated water available to their residents.

  • Fluoridation Around the World

Is the United States the only nation where fluoridation is used to prevent cavities? No. Although it started in the U.S., fluoridation is a strategy that many other countries have embraced as a proven practice for improving health. This report explores the more than 20 nations around the globe that provide fluoridated water to some or most of their residents.

This report examines how The Pew Charitable Trusts has strengthened advocacy for community water fluoridation. Public health advocates will learn the various roles that Pew has performed to support fluoridation, and the important lessons that should inform our ongoing efforts to advocate for this proven form of prevention. 


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52% }
of new military recruits couldn't be deployed because of dental problems.
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