Community Programs: Fluoridation

Grand Rapids, Michigan, became the first city in the world to fluoridate its community water in 1945. The rate of tooth decay among children in Grand Rapids dropped by 60%.

Tooth decay is the most prevalent childhood disease in our country, and it is completely preventable. Fluoridated community water is a key factor in reducing tooth decay for children and adults.

Why Fluoride?

First off, fluoride occurs naturally in the water – just not always at high enough levels to strengthen the enamel of teeth. That’s why it is added to the central, public water supply by so many communities in the U.S. Strong teeth equals fewer trips to the dentist, and that is nothing but good — no matter how much you like your dentist.

Now, some perspective. Before community water fluoridation, losing teeth early in life was commonplace. In the initial years of World War II, the U.S. Army rejected thousands of would-be soldiers due to bad teeth — the number of disqualifications “far exceeded all expectations,” the Army reported.

Times have changed. Today, nearly two-thirds of Americans drink fluoridated water, and many more benefit from food and drinks produced with fluoridated water. The portion of people aged 65+ losing all of their teeth have dropped by 21 percent since the early 1960s. But there is still work to do. Children – especially poor children – without access to fluoridated water continue to suffer unnecessarily from oral health problems.

Sure, brushing regularly with fluoride toothpaste helps. But recent studies have determined that this is not enough to fully protect teeth. The Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services continue to recommend community water fluoridation. Without fluoridated water, we’re brushing off our oral health and kissing millions of bright young smiles good-bye.

Get the facts and share them with your community.

Fluoridated Water is Harmless

“Fluoride is safe and effective for preventing and controlling cavities.”
The American Academy of Pediatricians says fluoride is safe and effective for preventing and controlling cavities.1 A 2010 study confirms that drinking fluoridated water as a child strengthens teeth, and makes tooth loss less likely later in life.2

1: AAPD Brochure, "Ask Your Dentist About Fluoride"
2: "The Association Between CommunityWater Fluoridation and Adult Tooth Loss." American Journal of Public Health, 2010.

How Flouride Works

Fluoride first mixes with saliva to neutralize acid in the mouth, heal teeth and protect them from future decay.

Fluoride then enters the bloodstream and combines with phosphate and calcium to strengthen teeth from the inside.

Fluoride Fast Facts

Fluoridated water reduces tooth decay by as much as 25 percent.

Source: U.S. Task Force on Community Preventive Services, 2002

Case Studies

All over the country, scientists have been studying the impact of water fluoridation. Here are a few of their findings:

  • A 2010 study in New York found that low-income residents in less fluoridated counties needed 33 percent more fillings, root canals and extractions than those in counties where fluoridated water was common.1
  • An Alaskan study released in 2011 shows that children living in non-fluoridated areas had a 32 percent higher rate of decayed, missing or filled teeth than children in fluoridated communities.2
  • The author of a 2010 fluoridation study concluded that the research confirms that “the most effective source of fluoride” is water fluoridation.3

1: “Geographic Variation in Medicaid Claims for Dental Procedures in New York State: Role of Fluoridation Under Contemporary Conditions,” Public Health Reports, 2010
2: “Dental Caries in Rural Alaska Native Children,” Morbidity and Morality Weekly Report, CDC, 2008
3: Pew Center on the States. “Water Fluoridation: Frequently Asked Questions.” 2011

Fluoridated Water is Inexpensive

Cities that fluoridate their water supply also see great health care cost savings. In a city the size of Wichita, every $1 invested in fluoride saves $38 in dental care. And community water fluoridation is the cheapest way to get fluoride.

Fluoridated Water is the Cheapest Way to Get Fluoride

  • 70 times cheaper than fluoride supplements
  • 1/2 the cost of fluoride rinses
  • Cheaper than varnishes and gels

“Recommendations for using fluoride to prevent and control dental caries in the United States.” Centers for Disease Control and Prevention, 2001

Fluoridated Fast Facts

Water fluoridation can save each person in our community as much as $18.62 a year in dental treatment costs.

“An Economic Evaluation of Community Water Fluoridation.” Journal of Public Health Dentistry, 2001

Fluoride Saves Medicaid Spending

When everyone has access to fluoridated water, fewer Medicaid dollars are spent on dental care. Those without dental care access benefit from better oral health, and we all benefit from less Medicaid spending.

“Water Fluoridation and Costs of Medicaid Treatment for Dental Decay.” Centers for Disease Control and Prevention, 1999

Fluoridated Water is Effective

Fluoridated drinking water has been called “one of the 10 great public health achievements of the 20th century” by the CDC, and is endorsed by such health authorities as the American Dental Association, the American Medical Association, the American Academy of Pediatrics and the U.S. Surgeon General.

An Ounce of Prevention

A single ounce of fluoride in every 5,000 gallons of city water can go a long way to saving our money, our mouths, and our future.

U.S. Military Bases are Fluoridated

In 2008, 52 percent of new recruits to the U.S. Armed Forces were categorized as having oral health problems needing urgent attention, which would delay overseas deployment. In 2011, a senior official with the Department of Defense reaffirmed the DoD policy of fluoridating water supplies for all military bases, pointing out that fluoridation will “directly reduce their risk for dental decay and improve [military] readiness.”

Memorandum by Jonathan Woodson, Assistant Secretary of Defense for Health Affairs, to U.S. Department of Defense facilities, July 18, 2011

Fluoridated Fast Facts

Every U.S. Surgeon General for the last 40 years has endorsed water fluoridation.

Health Experts Support Fluoride

Each of these leading health authorities publicly endorses community water fluoridation:

  • American Dental Association
  • American Medical Association
  • American Academy of Pediatrics
  • U.S. Surgeon General
  • World Health Organization
  • Centers for Disease Control and Prevention
  • American Public Health Association
  • International Association of Dental Research
  • American Association for Public Health Dentistry
  • National Institute of Dental and Craniofacial Research
  • Association of State and Territorial Dental Directors

Powerful Strategy

“Water fluoridation is a powerful strategy in our efforts to eliminate differences in health among people.”
- U.S. Surgeon General Richard H. Carmona, M.D

Fluoride in the U.S.

Currently, more than 204 million people in the United States are served by community water supplies containing enough fluoride to protect teeth.

Centers for Disease Control, 2012

Fluoridation-Related Links

Provided below are links to various agencies and organizations recognizing the benefits of community water fluoridation. Some of the agencies/organizations links are to policy statements and others provide educational information.

Evidence-based Clinical Recommendations

  • Professionally-Applied Topical Fluoride
  • Professionally-Applied Topical Fluoride (Executive Summary) (PDF)
  • Chairside Guide: Topical Fluoride (PDF)

Other Community Water Fluoridation Web Sites

  • American Dental Association
  • American Dental Hygienists' Association
  • Centers for Disease Control and Prevention (CDC)
  • FluorideWorks!
  • Healthy Teeth for a Lifetime

Community Water Fluoridation FAQs and Endorsements

  • The Council of State Governments Resolution on Community Water Fluoridation (May 10, 2006)