Overview

Community water fluoridation is a safe and effective way to prevent tooth decay.  The 2,900 members of the WDA represents the vast majority of the state's practicing dentists.  They are committed to promoting quality oral health care and support community water fluoridation. 

Fluoride has significant benefits for children and adults. In children, fluoride works with plaque and saliva to protect the tooth enamel and make it more resistant to the acid and bacteria that cause tooth decay.  For adults, fluoride can effectively reduce problems with dental caries (cavities).

Fluoride is a mineral that forms naturally in the earth's crust and there are traces of fluoride in virtually all water. However, sometimes that amount is not enough to prevent tooth decay so communities adjust the level of fluoride in their public water supplies to achieve a safe and effective amount (this is called optimal fluoridation). 

Learn more about how community water fluoridation is a cornerstone to good overall health.

Supporters of community water fluoridation

Oral health is critical to overall health. Numerous organizations have hailed community water fluoridation as safe and effective and a significant public health achievement.  They include (but are not limited to):

Frequently asked questions

How is fluoride good for my teeth?

Products such as toothpaste and mouth rinse that contain fluoride protect tooth enamel and can prevent cavities from forming on the surface and roots of the teeth.4  Tooth decay can affect a person's self-esteem and can cause cause significant pain and tooth loss.

In fact, Antigo, Wis. was the focal point of a landmark study.  As part of the study, Antigo ceased fluoridating its public water supply in 1960.  After only five years, second grade children had 200 percent more tooth decay.  In light of the results, Antigo promptly resumed fluoridating its public water supply and rates of tooth decay significantly decreased.8

There is a difference between natural fluoride and optimal fluoride.  Natural fluoride is fluoride that is found naturally in the water.  The Environmental Protection Agency (EPA) states the safe amount for natural fluoride is between 0.7 and 4.0 ppm (parts per million), although natural fluoride below 0.7 ppm would also be safe.  Optimal fluoride is the process of adjusting fluoride concentrations already present in water but not sufficient enough to prevent tooth decay. The safe amount for optimal fluoride is between 0.7 and 1.2 ppm.2  The Wisconsin Department of Health & Family Services states the recommended optimal fluoride concentration for community water fluoridation in Wisconsin is 1.1 ppm.

Yes. While fluoride has great benefits for children, those benefits are just as significant for adults. Tooth decay is often problematic for middle-aged and older adults, especially decay around the roots that results from a receding gumline.

Dental caries (cavities) is a disease that lasts a lifetime.  Community water fluoridation reduces tooth decay by 20-40 percent in children and 15-25 percent in adults.11 

Yes, fluoride is good for your health. The U.S. Centers for Disease Control and Prevention proclaimed community water fluoridation one of the 10 greatest public health achievements of the 20th century.  Numerous reports have documented that exposure to fluoridated water supplies, particularly during adolescence, can reduce cavity rates. It can reduce the amount of dental plaque bacteria which can lead to tooth decay and other oral health ailments. 

The vast majority of studies published in respected and peer-reviewed scientific journals conclude that community water fluoridation has no ill effects on health.4  

Does fluoride cause bone cancer?

No connection has been shown between cancer rates in humans and adding fluoride to drinking water.6  The National Cancer Institute has repeatedly stated that fluoridated water does not pose a detectable risk of cancer in humans.  Researchers examined this relationship in the U.S. during a 36-year period.  They examined more than 2.2 million cancer death records and 125,000 cancer case records and found no relationship between increased cancer risk and drinking fluoridated water.4  

Dental fluorosis is generally a mild condition characterized by lacy white lines or specks on the teeth.  It is also referred to as mottling of the tooth enamel. It is NOT harmful to a person's health.  It comes from sources not intended for use in conjunction with fluoridated water.  This includes dietary supplements or ingesting fluoride toothpaste.

Fluorosis is associated with ingesting fluoride during children's tooth forming years.  It can occur when the natural fluoride content is too high and children drink this water or ingest fluoride toothpaste while their permanent teeth are still forming.  The risk period may extend to age six or seven.11  

To avoid dental fluorosis, parents should teach their children who are younger than six years-old to minimize swallowing toothpaste and to only use a pea-sized amount on the brush.  Infants and toddlers need less fluoride than older children and teens.

The Wisconsin Department of Health and Family Services, Division of Public Health provides more information about dental fluorosis and specific information about the appropriate amount of fluoride for specific ages.

The National Research Council released a statement in March 2006 that addressed the levels of naturally occurring fluoride in drinking water.  The report does NOT call into question the safety of community water fluoridation.

The report concludes the EPA's maximum natural fluoride goal of 4 ppm be lowered to protect the public's health.  Just over 200,000 U.S. residents live in communities where fluoride levels in drinking water are 4 ppm or higher.1,10  The 4 ppm concentration of fluoride is nearly four times the optimum amount recommended by the U.S. Public Health Service, CDC and American Dental Association to prevent tooth decay.

Is community water fluoridation expensive?

According to the CDC, every dollar spent on water fluoridation saves from $7 to $42 in oral health treatment costs, depending on the size of the community.5  A 2001 report in the Journal of Public Health Dentistry estimates the annual cost for community water fluoridation in populations of 5,000 people or less at $2.94 to $3.44 per person.7

An article in the February 2008 Journal of the American Dental Association cites the work of dental colleagues at the Indiana University School of Dentistry who investigated whether access to fluoridated community water reduces the number of restorations placed in and associated costs incurred by children, adults and older adults. All three groups benefited, with older adults benefiting the most.3

Additional resources

1. American Dental Association. ADA Statement on Fluoride in Drinking Water: A Scientific Review of EPA's Standards. Press Release, March 2006.

2. American Dental Association. Exposure to Several Fluoride Sources May Explain Increase in Enamel Fluorosis, Journal Article Says. Press Release, Feb. 2002.

3. American Dental Association. "Older adults benefit most from fluoridation" (2008). Journal of the American Dental Association, 139, 133.

4. American Dental Association. "Water Fluoridation and Alleged Risk of Bone Cancer" (2005).

5. Centers for Disease Control. "Fact Sheet: Preventing Dental Caries with Community Programs" 2005. www.cdc.gov/OralHealth/factsheets/dental_caries.htm. 

6. Committee to Coordinate Environmental Health and Related Programs. Review of Fluoride Benefits and Risks: Report of the Ad Hoc Subcommittee on Fluoride. Public Health Service, Department of Health and Human Services, 1991.

7. Griffin, S.O., Jones, K. & S.L. Tomar (2001). An economic evaluation of community water fluoridation. Journal of Public Health Dentistry, 61, 78-86. 

8. Lemke, C., Doherty, J. & M. Arra (1970). Controlled fluoridation: The dental effects of discontinuation in Antigo, Wisconsin. Journal of the American Dental Association, 80, 782-786.

9. National Research Council. Carcinogenicity of fluoride. In: Subcommittee on Health Effects of Ingested Fluoride, editor. Health Effects of Ingested Fluoride. Washington DC: National Academy Press, 1993.

10. National Research Council. EPA Standard for Fluoride in Drinking Water Not Protective. Press Release, March 2006. http://www.ada.org/public/topics/fluoride/index.asp. 

11. Wisconsin Department of Health and Family Services. "Dental Health Fact Sheet: Fluoride" 2001. http://www.dhfs.state.wi.us/health/oral_health/pdf_files/pph4532.pdf.

For more information, check out the following Web sites:

• American Academy of Family Physicians
• American Dental Association
• U.S. Centers for Disease Control & Prevention
• Wisconsin Department of Health & Family Services

Contact

For more information on community water fluoridation and/or if you are involved with a local task force to improve the oral health of local residents, contact the Wisconsin Dental Association Executive Office at 414-276-4520.